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Efficacy and safety of corticosteroid in the treatment of hand osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Objective

To assess the efficacy and safety of corticosteroid therapy including oral corticosteroid and intra-articular corticosteroid in patients with hand osteoarthritis (OA), to provide treatment recommendations, and provide data-driven suggestions for future studies.

Methods

A systematic review of the literature was performed from inception to February 19, 2020, and the study was conducted on February 20, 2020. All controlled trials in Ovid MEDLINE, EMBASE, and Cochrane library reporting the efficacy on pain, functional recovery, and adverse events of corticosteroids in hand osteoarthritis were selected. The primary outcome was pain assessed on a visual analogue scale (VAS) lasting for up to 24 weeks. Pooled mean difference (MD) for continuous variable and risk ratio (RR) for dichotomous variable, with 95% confidence intervals (CIs), was assessed by a random effects model.

Results

Overall, seven trials totaling 511 participants were included in this study. The pooled analysis showed a significant difference in VAS pain (MD, − 5.75; 95% CI, − 10.08 to − 1.42, I2 = 40%). No significant differences were observed in any of the adverse events.

Conclusion

Our data suggest corticosteroids in hand OA might improve local pain and promote functional recovery. However, since these findings were based on only 7 studies and due to significant heterogeneity across the included studies, these findings need to be confirmed by future clinical trials with a higher number of patients.

Key Points:

• Current evidences of glucocorticoids for the management of hand osteoarthritis (OA) were insufficient and more evidences were needed.

• The results of the present meta-analysis revealed corticosteroids in hand OA might improve local pain and promote functional recovery.

• These findings need to be confirmed by future clinical trials with a higher number of patients.

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Authors and Affiliations

  1. Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China

    Xing Wang, Yu Zhang & Fang Fang

  2. Clinical Medical College, Chengdu University, Chengdu, Sichuan, China

    Peng Wang, Xi Zha & Yu Zhang

  3. Medical Center, University of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA

    Andrew Faramand

  4. Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA

    Weelic Chong

  5. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Yang Hai

Authors
  1. Xing Wang
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  2. Peng Wang
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  4. Xi Zha
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  8. Fang Fang
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Contributions

XW and YZ conceived the study and designed the protocol. XW and YZ performed the literature search. XW, PW, YZ, FF, AF, and XZ selected the studies and extracted the relevant information. XW, PW, YZ, FF, WC, YH, and AF synthesized the data. XW wrote the first draft of the paper. All authors critically revised successive drafts of the paper and approved the final version. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

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Correspondence to Fang Fang.

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Wang, X., Wang, P., Faramand, A. et al. Efficacy and safety of corticosteroid in the treatment of hand osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rheumatol 41, 1825–1832 (2022). https://doi.org/10.1007/s10067-021-06024-8

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  • DOI: https://doi.org/10.1007/s10067-021-06024-8

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