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Erosive hand osteoarthritis (OA) of the interphalangeal (IP) joints is characterised by a more pronounced inflammatory burden of disease.1 Whether it is a subset of hand OA or just a radiographic phase remains a matter of debate. The pathogenesis of erosive OA is not yet understood, but articular cartilage degeneration and subchondral bone resorption are some of the major characteristics. In general, several cytokine-driven pathways such as receptor activator of nuclear factor κB, interleukin-1 and tumour necrosis factor (TNF) alpha are involved at the level of the subchondral bone-inducing dynamic morphological changes.2–4 In post hoc analyses in two recent placebo-controlled pilot studies in erosive OA, it was shown that adalimumab and etanercept were able to diminish structural progression after 1 year of treatment in a subgroup of patients who showed soft tissue swelling at baseline.5 ,6
We hypothesised …
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