Hydroxychloroquine: Another Battle Lost in the Campaign to Find Effective Therapies for Hand Osteoarthritis
Authors: Elena Losina, Jeffrey N. Katz
Journal: Annals of Internal Medicine (2018)

Editorials20 March 2018Hydroxychloroquine: Another Battle Lost in the Campaign to Find Effective Therapies for Hand OsteoarthritisElena Losina, PhD and Jeffrey N. Katz, MD, MScElena Losina, PhDBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (E.L., J.N.K.)Search for more papers by this author and Jeffrey N. Katz, MD, MScBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (E.L., J.N.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-0035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Symptomatic hand osteoarthritis affects 1 in 12 older adults (1) and typically involves the distal and proximal interphalangeal (DIP and PIP) joints and the carpometacarpal joint of the thumb. Symptoms affect a person's ability to perform basic activities of daily living, including eating, cooking, and dressing, as well as more complex occupational and recreational tasks. No therapies modify or arrest the progression of damage to cartilage and bone. Hence, treatment of hand osteoarthritis is focused on symptom relief (2). Patients with symptomatic hand osteoarthritis are typically prescribed acetaminophen, nonsteroidal anti-inflammatory drugs, and—if these agents do not provide sufficient relief—opioids. Identification ...References1. Dillon CF, Hirsch R, Rasch EK, Gu Q. Symptomatic hand osteoarthritis in the United States: prevalence and functional impairment estimates from the third U.S. National Health and Nutrition Examination Survey, 1991-1994. Am J Phys Med Rehabil. 2007;86:12-21. [PMID: 17304684] CrossrefMedlineGoogle Scholar2. Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, et al. 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[PMID: 25834142] doi:10.1136/annrheumdis-2015-207241 CrossrefMedlineGoogle Scholar6. Gaujoux-Viala C, Smolen JS, Landewé R, Dougados M, Kvien TK, Mola EM, et al. Current evidence for the management of rheumatoid arthritis with synthetic disease-modifying antirheumatic drugs: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis. 2010;69:1004-9. [PMID: 20447954] doi:10.1136/ard.2009.127225 CrossrefMedlineGoogle Scholar7. Canadian Hydroxychloroquine Study Group. A randomized study of the effect of withdrawing hydroxychloroquine sulfate in systemic lupus erythematosus. N Engl J Med. 1991;324:150-4. [PMID: 1984192] CrossrefMedlineGoogle Scholar8. Kingsbury SR, Tharmanathan P, Keding A, Ronaldson SJ, Grainger A, Wakefield RJ, et al. Hydroxychloroquine effectiveness in reducing symptoms of hand osteoarthritis. A randomized trial. Ann Intern Med. 2018;168:385-95. doi:10.7326/M17-1430 LinkGoogle Scholar9. Punzi L, Bertazzolo N, Pianon M, Michelotto M, Todesco S. Soluble interleukin 2 receptors and treatment with hydroxychloroquine in erosive osteoarthritis [Letter]. J Rheumatol. 1996;23:1477-8. [PMID: 8856633] MedlineGoogle Scholar10. Kortekaas MC, Kwok WY, Reijnierse M, Wolterbeek R, Bøyesen P, van der Heijde D, et al. Magnetic resonance imaging in hand osteoarthritis: intraobserver reliability and criterion validity for clinical and structural characteristics. J Rheumatol. 2015;42:1224-30. [PMID: 25979715] doi:10.3899/jrheum.140338 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (E.L., J.N.K.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0035.Corresponding Author: Elena Losina, PhD, Policy Innovation eValuations in Orthopedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, 60 Fenwood Road, BTM 5-016, Boston, MA 02115; e-mail, [email protected]harvard.edu.Current Author Addresses: Drs. Losina and Katz: Policy Innovation eValuations in Orthopedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, 60 Fenwood Road, BTM 5-016, Boston, MA 02115.This article was published at Annals.org on 20 February 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHydroxychloroquine Effectiveness in Reducing Symptoms of Hand Osteoarthritis Sarah R. Kingsbury , Puvan Tharmanathan , Ada Keding , Sarah J. Ronaldson , Andrew Grainger , Richard J. Wakefield , Catherine Arundel , Fraser Birrell , Michael Doherty , Tonia Vincent , Fiona E. Watt , Krysia Dziedzic , Terence W. O'Neill , Nigel K. Arden , David L. Scott , John Dickson , Toby Garrood , Michael Green , Ajit Menon , Tom Sheeran , David Torgerson , and Philip G. Conaghan Metrics 20 March 2018Volume 168, Issue 6Page: 442-443KeywordsDrugsHydroxychloroquineInflammationMagnetic resonance imagingOrthopedicsOsteoarthritisPathogenesisPhenotypesRheumatoid arthritisUltrasound imaging ePublished: 20 February 2018 Issue Published: 20 March 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...