Background Erosive hand OA is considered a subtype of hand OA characterized by a marked inflammatory component, more aggressive disease and in most cases a major functional impairment in patients of middle age. Despite this, so far now we do not have a treatment option that had shown to be effective in clinical management of this disease.
Objectives The aim of this study is to evaluate the effectiveness of Hydroxychloroquine (HCQ) in the symptomatic control of erosive hand osteoartritis after 24 weeks of treatment.
Methods We performed a prospective open study. Consecutive patients with symptomatic hand OA despite NSAIDs/analgesics treatment fulfilling the American College of Rheumatology (ACR) criteria, with at least one erosion on hands radiography and pain VAS ≥40 mm without contraindication to HCQ treatment were included. Demographics data, hypertension, diabetes, dyslipidemia, and clinical presentation, were collected. Joint tenderness and swelling basal and after 24 weeks were assessed. Pain, joint stiffness and disability were assessed by the Australian/Canadian OA hand index (AUSCAN visual analog scale version) and HAQ. Tolerance and side effects was also registered.
Results A total of 10 patients were included between July 2012 and July 2013 and all completed a 24 weeks follow up. There was a marked female predominance of 100% (even greater than expected) with a mean age of 57,7±9,2 and a mean disease duration of 6,5±6,17 years. Attending to cardiovascular risk factors, we found a prevalence of 60% hypercholesterolemia, 50% of hypertension, and no case of type II diabetes. With regard to clinical presentation we found 40% hands and feet OA, 20% generalized and 40% hands limited. Basal and after 24 weeks treatment clinical data are given in table 1. There was no major side effects. A 50% of patients reached a reduction of at least 20% of pain assessment by AUSCAN pain domain but only 36% of patiente reported to be better after 24 weeks of treatment.
Conclusions Our results suggest that hydroxychloroquine may decrease inflammatory activity in erosive hands OA and thus functional impairment after 24 weeks of treatment but seems to have limited effect on global pain. Hydroxychloroquine was well tolerated and no major side effects were observed.
Disclosure of Interest None declared