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Hand OA: Low-dose Corticosteroids Improve Symptoms

Presented By
Dr Féline Kroon, Prof. Christian Roux
ACR 2019

In the HOPE trial, a low-dose therapy with corticosteroids substantially reduced pain and decreased signs of inflammation in patients with painful hand osteoarthritis (OA) [1].

Hand OA is one of the most common OA phenotypes, and it has a high clinical burden. It leads to joint pain, disability, decreased hand strength, and reduced quality of life. The rationale of the HOPE trial has been that synovial inflammation is often present in people with hand OA and is a main determinant of both pain and disease progression, as previous data has shown. Therefore, corticosteroids might be a benefit due to their potent anti-inflammatory effect.

The HOPE trial enrolled patients with signs of synovial inflammation who met the ACR criteria for painful hand OA. Patients with ≥4 osteoarthritic nodes involving interphalangeal joints, ≥1 interphalangeal joint with soft tissue swelling or erythema, and ≥1 positive power Doppler signal or synovitis of grade 2 or highe...

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