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A randomized, double-blind, placebo-controlled trial of low-dose oral prednisolone for treating painful hand osteoarthritis.
- Source :
-
Rheumatology . Dec2012, Vol. 51 Issue 12, p2286-2294. 9p. 1 Diagram, 2 Charts, 2 Graphs. - Publication Year :
- 2012
-
Abstract
- Objective. Anti-inflammatory therapies are effective analgesics for OA. This study determined whether low-dose oral prednisolone (PNL) was an effective analgesic for hand OA.Methods. This was a randomized, double-blind, placebo-controlled trial of people with ACR criteria hand OA and baseline hand pain visual analogue scale (VAS) of >40/100 mm. Participants received 5 mg PNL or placebo daily for 4 weeks. Pain VAS, disease activity VAS, Australian/Canadian Hand Osteoarthritis Index and joint counts were performed at baseline, 4 and 12 weeks. Primary outcome was the change in hand pain VAS at 4 weeks. Analysis of covariance was used for analysis, controlling for baseline values. To explore potential mechanism of action of PNL, non-contrast 0.2 Tesla MRI was performed on the most painful hand at baseline and 4 weeks.Results. A total of 70 participants were recruited (57 women, mean age 61 years, mean baseline pain VAS 61.5 mm); 75% had more than one joint with definite MRI synovitis/effusion. At 4 weeks the adjusted mean reduction in pain VAS was 19.9 mm (PNL group) and 16.8 mm (placebo group) (P = 0.54). There were no statistically significant differences in VAS, Australian/Canadian Hand Osteoarthritis Index or joint counts between placebo and PNL groups at 4 or 12 weeks. A total of 20 participants in each group achieved an Outcome Measures in Rheumatology-Osteoarthritis Research Society International response. Baseline synovitis/effusion did not predict response to treatment.Conclusion. This is the first randomized controlled trial of low-dose corticosteroid alone for painful hand OA, which demonstrated that short-term low-dose oral PNL is not an effective analgesic treatment for hand OA.Trial registration. International Standard Randomised Controlled Trial Number Register, www.isrctn.org, Trial number 99697616. [ABSTRACT FROM PUBLISHER]
- Subjects :
- *HAND radiography
*ACADEMIC medical centers
*ANALYSIS of covariance
*CHI-squared test
*CONFIDENCE intervals
*EPIDEMIOLOGY
*HAND
*MAGNETIC resonance imaging
*ORAL drug administration
*OSTEOARTHRITIS
*PAIN
*PLACEBOS
*QUESTIONNAIRES
*RESEARCH funding
*T-test (Statistics)
*U-statistics
*DATA analysis
*EQUIPMENT & supplies
*RANDOMIZED controlled trials
*VISUAL analog scale
*BLIND experiment
*DATA analysis software
*DESCRIPTIVE statistics
*PREDNISOLONE
*DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 14620324
- Volume :
- 51
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 83932661
- Full Text :
- https://doi.org/10.1093/rheumatology/kes219