Efficacy of conservative treatments for hand osteoarthritis: an umbrella review of intervention studies

Veronese, Nicola and Punzi, Leonardo and Smith, Lee and Bolzetta, Francesco and Cester, Alberto and Demurtas, Jacopo (2020) Efficacy of conservative treatments for hand osteoarthritis: an umbrella review of intervention studies. Wiener Klinische Wochenschrift: The Central European Journal of Medicine. ISSN 1613-7671

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Official URL: https://doi.org/10.1007/s00508-020-01702-0

Abstract

Background: Hand osteoarthritis (OA) is common, but the efficacy/safety of treatment interventions aimed to improve health outcomes in this population are not well understood. Therefore, the aim of this study was to map and grade the effect of interventions for health outcomes in hand OA. Methods: Umbrella review of systematic reviews with meta-analyses of randomized controlled trials (RCTs) using placebo/no intervention as control group. For outcomes with a p-value <0.05, the certainty of the evidence was evaluated using the grading of recommendations assessment, development and evaluation (GRADE) assessment. Results: From 189 abstracts, 9 meta-analyses (24 outcomes) were included, with 8 reporting significant summary results. The use of splints was associated with reduced pain at medium term in thumb carpometacarpal OA (standardized mean difference [SMD] = −0.70; 95% confidence intervals [95% CI]: −1.05 to −0.35; low certainty), reduced pain in long follow-up RCTs in symptomatic hand OA (SMD = −0.80; 95% CI: −1.16; −0.45; moderate certainty), and better function (SMD = 0.42; 95% CI: 0.08; 0.70; low certainty). The use of resistance training (SMD = −0.27; 95% CI: −0.47; −0.07) or physical exercise (SMD = −0.23; 95% CI: −0.42; −0.04) in improving hand pain and in improving finger joint stiffness (SMD = −0.36; 95%CI: −0.58; −0.15) was supported by a moderate certainty of evidence. The use of intra-articular hyaluronic acid in improving function (MD = 1.12; 95% CI: 0.61; 1.64; moderate certainty of evidence) was the only statistically significant pharmacological intervention. Conclusion: Only some non-pharmacological interventions are effective in improving health outcomes in hand OA and this evidence is supported by a moderate/low certainty, indicating the necessity of further interventional research.

Item Type: Journal Article
Keywords: hand osteoarthritis, umbrella review, randomized controlled trial, physical activity, splint
Faculty: Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 05 Jun 2020 13:56
Last Modified: 21 Jul 2020 09:50
URI: http://arro.anglia.ac.uk/id/eprint/705615

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