Hydroxychloroquine Effectiveness in Reducing Symptoms of Hand Osteoarthritis

Kingsbury, Sarah R.; Tharmanathan, Puvan; Keding, Ada; Ronaldson, Sarah; Grainger, Andrew J.; Wakefield, Richard J.; Arundel, Catherine; Birrell, Fraser; Doherty, Michael; Vincent, Tonia L.; Watt, Fiona E.; Dziedzic, Krysia; O'Neill, Terence W; Arden, N K; Scott, David; Dickson, John; Garrood, Toby; Green, Michael; Menon, Ajit; Sheeran, Tom; Torgerson, David; Conaghan, Philip G.

doi:10.7326/m17-1430

Cited by 66 publications

(76 citation statements)

References 49 publications

(33 reference statements)

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“…[H2] Sex hormones and hand OA All types of OA have a higher prevalence in post-menopausal women than in pre-menopausal women, but the relationship that hand OA has with the typical time of the menopause onset seems to be unique and robust 26,145 . For instance, perimenopausal symptoms (such as hot flushes, irregular menstrual cycles) commonly occur at the time of presentation with hand OA 145 . Whether this relationship is due to the loss of the established anti-inflammatory and pro-reparative effects of oestrogen or related to fluctuations in other sex hormones is currently unclear.…”

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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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Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

et al. 2018

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“…Kingsbury и соавт. [51] включили в многоцентровое плацебоконтролируемое исследование HERO (Hydroxychloroquine Effectiveness in Reducing symptoms of hand Osteoarthritis) 248 пациентов с умеренной и сильной болью, не поддающейся терапии НПВП и опиоидами. Все участники исследования получали ГХ в дозе 200; 300 или 400 мг/сут, в зависимости от массы тела (максимально 6,5 мг/кг/сут), или плацебо на протяжении 12 мес.…”

Section: гидроксихлорохин (гх)unclassified

“…Отрицательные результаты крупных исследований вызывают вопросы о целесообразности применения ГХ в терапии ОА. Высказываются предположения о слабой противовоспалительной активности ГХ у лиц с ОА, отсутствии ключевых механизмов патогенеза, на которые мог бы воздействовать этот препарат [51]. Остается открытым вопрос и об эффективности ГХ при ЭОА и ОА с высокой воспалительной активностью и выраженным синовитом, выпотом в коленных, тазобедренных и других крупных суставах и неэффективностью традиционной терапии, что отражает разные фенотипы этого гетерогенного заболевания.…”

Section: гидроксихлорохин (гх)unclassified

Use of disease-modifying anti-rheumatic drugs in the therapy of osteoarthritis

Германович¹,

Алексеева²,

Лила³

2019

Sovremennaâ revmatologiâ

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Osteoarthritis (OA) is a heterogeneous disease with varying degrees of inflammatory responses, structural changes, functional insufficiency, and disease progression as a whole. Some OA phenotypes are characterized by a high local inflammatory response, persistent pain, persistent synovitis, and severe functional limitation. As a rule, the use of traditional nonsteroidal anti-inflammatory drugs in these patients and the injection of glucocorticoids into the joint show no substantial effect. Taking into account the important role of inflammation and the involvement of immune responses in the pathogenesis of OA, the existence of its erosive forms, the use of some disease-modifying anti-rheumatic drugs could be a rational solution of the problem in the therapy of this disease.The paper reviews data on the efficiency and safety of using methotrexate and hydroxychloroquine in OA.

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“…Hydroxychloroquine is no more effective than placebo in reducing the symptoms of hand osteoarthritis, a study published in the Annals of Internal Medicine has found 1. The UK researchers said that their findings do not support the current practice of off-label use of hydroxychloroquine in patients with hand osteoarthritis.…”

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confidence: 97%

“…The study,1 which was funded by Arthritis Research UK, took place in 13 primary and secondary care centres in England. Researchers randomly assigned 248 patients with symptomatic and nodal hand osteoarthritis to receive either hydroxychloroquine (200-400 mg) or placebo, in addition to their usual care.…”

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confidence: 99%