Treating painful hand OA using low dose oral prednisolone

• Research type

  Research Study

• Full title

  Treating painful hand osteoarthritis using low dose oral prednisolone- assessing short-term pain and imaging outcomes

• IRAS ID

  17257

• Contact name

  Philip Conaghan

• Sponsor organisation

  University of Leeds

• Eudract number

  2009-011173-32

• ISRCTN Number

  N/A

• Clinicaltrials.gov Identifier

  N/A

• Research summary

  Osteoarthritis (OA) is the most common type of arthritis worldwide and a major cause of disability and health care expenditure. Over 8 million people in the UK have OA and with an ageing population this will increase. The OA Nation survey, 2003 found that 81% of people with OA are in constant pain or limited in performing everyday tasks. Painful hand OA is a common problem; 26% of women and 13% of men over the age of 70 have symptomatic OA in at least one hand joint. Significant difficulty with day-to-day tasks is a widespread complaint.Current treatments for painful hand OA, including topical anti-inflammatory gels, painkillers and steroid injections, are limited by both toxicity and duration of action. Other treatments are therefore needed. Recent imaging studies have demonstrated that synovitis (inflammation of the lining of the joint) is common in OA. Synovitis has been associated with pain in both knee and hand OA. Hence by reducing synovitis in OA joints, we would hope to reduce pain.Steroids are effective at reducing synovitis and have been shown to reduce pain in OA when given by injection into the joint or by intramuscular injection.This study is a randomised, double-blind, placebo-controlled trial to compare the effectiveness of the oral steroid prednisolone versus placebo in a group of patients with painful hand OA (at least 40mm on a 0-100mm visual analogue pain scale). Patients will take 5mg prednisolone or placebo daily for 4 weeks. The primary outcome of this study is change in hand pain after 4 weeks. Hand pain will also be assessed after 12 weeks and patients will have magnetic resonance imaging of their hands to assess changes in synovitis during the treatment period. If effective, this would offer a simple treatment option for use in primary and secondary care.

• REC name

  Yorkshire & The Humber - Leeds West Research Ethics Committee

• REC reference

  09/H1307/53

• Date of REC Opinion

  22 May 2009

• REC opinion

  Further Information Favourable Opinion