Efficacy of Hydroxychloroquine in Hand Osteoarthritis: A Randomized, Double‐Blind, Placebo‐Controlled Trial

Lee, Weiching; Ruijgrok, Liesbeth; Klerk, Bianca Boxma–de; Kok, Marc R.; Kloppenburg, Margreet; Gerards, A.; Huisman, Margriet A.; Hazes, M.; Sonnaville, P. de; Grillet, Bart; Weel, A.; Basoski, N.

doi:10.1002/acr.23471

Cited by 62 publications

(70 citation statements)

References 27 publications

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“…However, the 2007 recommendations did not include advice on the use of these drugs, and no evidence was available at that time. Trials investigating the efficacy of hydroxychloroquine,53 69 70 different TNF-inhibitors71–74 and anti-interleukin-1,75 could not demonstrate efficacy of these antirheumatic drugs in patients with hand OA. Trials investigating methotrexate, sulfasalazine or colchicine have not been performed.…”

Section: Resultsmentioning

confidence: 99%

2018 update of the EULAR recommendations for the management of hand osteoarthritis

et al. 2018

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Since publication of the European League Against Rheumatism (EULAR) recommendations for management of hand osteoarthritis (OA) in 2007 new evidence has emerged. The aim was to update these recommendations. EULAR standardised operating procedures were followed. A systematic literature review was performed, collecting the evidence regarding all non-pharmacological, pharmacological and surgical treatment options for hand OA published to date. Based on the evidence and expert opinion from an international task force of 19 physicians, healthcare professionals and patients from 10 European countries formulated overarching principles and recommendations. Level of evidence, grade of recommendation and level of agreement were allocated to each statement. Five overarching principles and 10 recommendations were agreed on. The overarching principles cover treatment goals, information provision, individualisation of treatment, shared decision-making and the need to consider multidisciplinary and multimodal (non-pharmacological, pharmacological, surgical) treatment approaches. Recommendations 1-3 cover different non-pharmacological treatment options (education, assistive devices, exercises and orthoses). Recommendations 4-8 describe the role of different pharmacological treatments, including topical treatments (preferred over systemic treatments, topical non-steroidal anti-inflammatory drugs (NSAIDs) being first-line choice), oral analgesics (particularly NSAIDs to be considered for symptom relief for a limited duration), chondroitin sulfate (for symptom relief), intra-articular glucocorticoids (generally not recommended, consider for painful interphalangeal OA) and conventional/biological disease-modifying antirheumatic drugs (discouraged). Considerations for surgery are described in recommendation 9. The last recommendation relates to follow-up. The presented EULAR recommendations provide up-to-date guidance on the management of hand OA, based on expert opinion and research evidence.

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Section: Resultsmentioning

confidence: 99%

2018 update of the EULAR recommendations for the management of hand osteoarthritis

et al. 2018

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“…Retinoic acid is essential for forelimb development in the embryo and is a potentially interesting target as this metabolite has anti-inflammatory effects on many different cell types including chondrocytes 143 . Paradoxically, chondrocyte biologists use retinoic acid to stimulate cartilage catabolism (albeit at supra-physiological levels 144 .…”

Section: [H1] Disease Mechanismsmentioning

confidence: 99%

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

et al. 2018

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Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease.

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“…Evidence sug gests that hydroxychloroquine can delay or prevent organ damage 10 , including bone destruction 11 , in autoimmunity, and that this drug has antithrombotic effects 12 . Trials assessing antimalarial drugs in hand osteoarthritis, how ever, have found that hydroxychloroquine is no more effective than placebo in providing pain relief 13,14 , implying that although antimalarial drugs are useful for a selection of rheumatic diseases, they are not 'wonder drugs' .…”

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confidence: 99%

Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology

2020

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Efficacy of Hydroxychloroquine in Hand Osteoarthritis: A Randomized, Double‐Blind, Placebo‐Controlled Trial

Abstract: Treatment with HCQ at 24 weeks is not effective in reducing the symptoms of hand OA compared to placebo.

Cited by 62 publications

References 27 publications

2018 update of the EULAR recommendations for the management of hand osteoarthritis

2018 update of the EULAR recommendations for the management of hand osteoarthritis

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology

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