TY - JOUR
T1 - Pharmacological therapies for osteoarthritis of the hand
T2 - A review of the evidence
AU - Altman, Roy D.
N1 - Funding Information:
The author has received research grants from Novartis and Ferring; consulting fees from Endo, Novartis, Ferring and Rottapharma; and participated in speaker’s bureaus for Ferring and Forest. Jeffrey Coleman, MA, and Robert Gatley, MD, of Complete Healthcare Communications, Inc. (Chadds Ford, PA, USA) provided editorial support for this article (literature search, document retrieval, translation, medical writing and copy editing), with funding from Endo Pharmaceuticals Inc. (Chadds Ford, PA, USA). Endo Pharmaceuticals made no contribution to the content of this manuscript.
Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2010
Y1 - 2010
N2 - Osteoarthritis (OA) of the hand is highly prevalent in US senior citizens, developing in >50 of individuals aged >60 years. Hormonal, genetic and inflammatory mechanisms are known to increase the risk of hand OA and influence the course of the disease. However, the underlying processes in the development of hand OA are not well understood, and there is no known disease-modifying drug. Likewise, surgical interventions for affected hand joints have not proven as successful as joint replacement for the knee or hip. Current treatment of hand OA focuses on reducing pain and improving patient function to improve quality of life. Pharmacological approaches have included several oral therapies, such as paracetamol (acetaminophen), oral nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, all of which carry a risk of adverse events that typically increases with age. Topical NSAIDs, recently approved in the US, appear to provide efficacy similar to that of oral NSAIDs for hand OA, with less systemic NSAID exposure. Intra-articular corticosteroids and hyaluronic acid have also shown modest symptomatic efficacy with generally good tolerability. Two proposed disease-modifying therapies, chondroitin sulfate and hydroxychloroquine, have had unclear effects on disease modification in clinical trials. This review of pharmacotherapies for the treatment of hand OA focuses on their efficacy and safety in elderly patients. Articles cited herein were identified via a search of PubMed from January 2005 to November 2009. The bibliographies of articles identified through this search were searched manually for additional references of interest.
AB - Osteoarthritis (OA) of the hand is highly prevalent in US senior citizens, developing in >50 of individuals aged >60 years. Hormonal, genetic and inflammatory mechanisms are known to increase the risk of hand OA and influence the course of the disease. However, the underlying processes in the development of hand OA are not well understood, and there is no known disease-modifying drug. Likewise, surgical interventions for affected hand joints have not proven as successful as joint replacement for the knee or hip. Current treatment of hand OA focuses on reducing pain and improving patient function to improve quality of life. Pharmacological approaches have included several oral therapies, such as paracetamol (acetaminophen), oral nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, all of which carry a risk of adverse events that typically increases with age. Topical NSAIDs, recently approved in the US, appear to provide efficacy similar to that of oral NSAIDs for hand OA, with less systemic NSAID exposure. Intra-articular corticosteroids and hyaluronic acid have also shown modest symptomatic efficacy with generally good tolerability. Two proposed disease-modifying therapies, chondroitin sulfate and hydroxychloroquine, have had unclear effects on disease modification in clinical trials. This review of pharmacotherapies for the treatment of hand OA focuses on their efficacy and safety in elderly patients. Articles cited herein were identified via a search of PubMed from January 2005 to November 2009. The bibliographies of articles identified through this search were searched manually for additional references of interest.
KW - corticosteroids, therapeutic use
KW - elderly
KW - hyaluronic-acid, therapeutic use
KW - nonsteroidal-anti-inflammatories, therapeutic use
KW - opioid-analgesics, therapeutic use
KW - osteoarthritis, treatment
KW - paracetamol, therapeutic use.
UR - http://www.scopus.com/inward/record.url?scp=77956313655&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77956313655&partnerID=8YFLogxK
U2 - 10.2165/11539010-000000000-00000
DO - 10.2165/11539010-000000000-00000
M3 - Review article
C2 - 20809663
AN - SCOPUS:77956313655
VL - 27
SP - 729
EP - 745
JO - Drugs and Aging
JF - Drugs and Aging
SN - 1170-229X
IS - 9
ER -