No More Hydroxychloroquine for Hand OA?

New research from the Netherlands has found that when it comes to hand osteoarthritis (OA), use of the disease-modifying anti-rheumatic drug hydroxychloroquine (HCQ) for 24 weeks did not diminish mild-moderate pain when compared with placebo. The researchers also found that using HCQ didn’t result in any overall improvement in physical, social and emotional wellbeing.

“The findings from our trial do not support the prescription of hydroxychloroquine for patients with mild-moderate pain from hand osteoarthritis, neither on a physical nor emotional level, ” said Natalja M. Basoski, lead researcher, of the Department of Rheumatology, Maasstad Ziekenhuis, Rotterdam, Netherlands, in the June 13, 2015 news release. “However, further investigations will need to be performed to determine whether hydroxychloroquine relieves pain in other specific phenotypes of hand OA, ” she added.

Basoski told OTW, “Patients were recruited from outpatient rheumatology clinics from six different hospitals, including one university medical center, in and around Rotterdam. Patients ≥ 40 years of age, with primary hand OA according to the ACR [American College of Rheumatology] classification criteria were included. Patients with ≥ 1 hand joint with a Kellgren and Lawrence grade 4 were excluded. Hand pain symptoms and independent of level of severity had to be present for at least one year.”

“Patients were randomly assigned to receive either HCQ 400 mg once a day or placebo for a treatment period of 24 weeks. Paracetamol was used as rescue medication and patients were allowed to continue all comedication except NSAIDs during the study. If patients were using NSAIDs, inclusion was allowed after a wash out period of one week.”