Future research agenda
| No | Proposition |
|---|---|
| 1 | Clinical trials on hand OA should separately consider the localisation (thumb base, interphalangeal joints) and the stage or type of OA (non-erosive, erosive, nodal) and examine clinical predictors of response |
| 2 | Thorough evaluation is required of physical treatments, such as ultrasound, laser, TENS, and local application of heat (for example, paraffin wax, hot pack) |
| 3 | Studies are required to determine the most appropriate form or combination of exercise (for example, strengthening, range of movement) for the different subsets of hand OA |
| 4 | Further studies are required to better evaluate the symptom and structure modifying effects of SYSADOA |
| 5 | The benefits of intra-articular injection of either corticosteroid or hyaluronan should be determined both for thumb base and interphalangeal OA |
| 6 | Existing slow acting antirheumatic drugs and biological agents (especially anti-tumour necrosis factor therapy) should be investigated in erosive interphalangeal OA, to determine possible symptom benefits and structure modifying effects |
| 7 | The efficacy and safety (both short and long term) of paracetamol, weak opioids, and oral NSAIDs need to be assessed and compared |
| 8 | The potential benefits of surgery compared with conservative management, and the most appropriate surgical procedure for thumb base OA, remain to be determined |