Document Detail

A randomized, double-blind, placebo-controlled trial of low-dose oral prednisolone for treating painful hand osteoarthritis.
MedLine Citation:
PMID:  22956551     Owner:  NLM     Status:  MEDLINE    
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,, Trial number 99697616.
Claire Y J Wenham; Elizabeth M A Hensor; Andrew J Grainger; Richard Hodgson; Sharon Balamoody; Caroline J Doré; Paul Emery; Philip G Conaghan
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-09-06
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  51     ISSN:  1462-0332     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-03     Completed Date:  2013-02-01     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  2286-94     Citation Subset:  AIM; IM    
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MeSH Terms
Administration, Oral
Aged, 80 and over
Analgesics / administration & dosage*
Analysis of Variance
Anti-Inflammatory Agents / administration & dosage*
Double-Blind Method
Magnetic Resonance Imaging
Middle Aged
Musculoskeletal Pain / prevention & control*
Osteoarthritis / complications,  drug therapy*,  pathology
Pain Measurement
Prednisolone / administration & dosage*
Synovitis / pathology
Treatment Outcome
Grant Support
MC_U122886349//Medical Research Council
Reg. No./Substance:
0/Analgesics; 0/Anti-Inflammatory Agents; 0/Capsules; 9PHQ9Y1OLM/Prednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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