Hydroxychloroquine is no more effective than placebo for relieving moderate to severe hand pain and radiographic osteoarthritis. The findings of a randomized trial are published in Annals of Internal Medicine.
Symptomatic hand osteoarthritis affects up to 31 percent of adults over the age of 70 and up to 15 percent of those over the age of 60. The pain can be debilitating and few therapies are effective. As such physicians seek alternatives to improve quality of life for patient suffering from hand osteoarthritis. Hydroxychloroquine has been used as an off-label treatment, but data on its efficacy is sparse.
Researchers from the Leeds Institute of Rheumatic and Musculoskeletal Medicine and NIHR Leeds Biomedical Research Centre randomly assigned 248 participants with symptomatic and radiographic hand osteoarthritis to either hydroxychloroquine (200 to 400 mg) or placebo for 12 months with ongoing usual care. The goal was to determine the effectiveness of hydroxychloroquine versus placebo as an analgesic treatment. At 6 months, mean hand pain was 5.49 points in the placebo group and 5.66 points in the hydroxychloroquine group. The authors concluded that hydroxychloroquine was no more effective than placebo for pain relief. According to the researchers, these findings do not support the current practice of off-label use of hydroxychloroquine in patients with hand osteoarthritis.
The researchers also noted that a lot of hand pain may be caused by tendon problems, rather than arthritis, which hydroxychloroquine would not have helped.
Patients with primary hand OA should not be prescribed hydroxychloroquine