Risk Factors for Progression in Hand Osteoarthritis: A Systematic Review

Abstract

Objective. To assess the risk factors for progression of hand osteoarthritis (OA).Methods. In a systematic review of cohort studies, medical literature databases were searched up to May 2012 for articles reporting data on the association between risk factors and hand OA progression. The quality of these studies was assessed by 2 independent reviewers using a criteria scoring system of 16 items, and studies were dichotomized into those with scores of 69% or over and those with scores under 69%. Best evidence synthesis was used to determine the level of evidence per risk factor. Results. In total, 14 articles that fulfilled the selection criteria were included, of which 8 were high quality. The most frequently investigated risk factors were age, sex, radiographic features (e.g., erosive OA), and scintigraphy. Progression was mostly defined by radiographic criteria, but also clinical progression as an outcome was described. Most of the investigated risk factors showed limited or inconclusive evidence for an association with hand OA progression. Limited evidence according to the best evidence synthesis with most available studies was present for the association between a positive scintigraphic scan and radiographic progression (up to 2.8 times more progression than negative joints). Conclusion. Limited evidence is available for a positive association between an abnormal scintigraphic scan and radiographic hand OA progression. These data suggest that a positive scintigraphic scan as an inclusion criterion for studies that aim to show structural modification can increase the power of such studies. Future longitudinal studies with a well-defined baseline population are needed to search for risk factors of hand OA progression.

What is the evidence for the presence of a therapeutic window of opportunity in rheumatoid arthritis? A systematic literature review

“…A qualitative review was performed instead. Strengths of the current approach are that two independent readers scored all the articles, that criteria for evaluation of the quality were in line with those of previous studies,6 7 and that predefined and stringent qualitative levels of evidence8 were used to summarise the data (strong evidence was defined as ≥75% of the HQ studies reporting an effect in the same direction). With this approach, we tried to optimise the accuracy of this systematic qualitative literature review.…”

“…The quality of each included paper was reviewed by two reviewers independently (JABvN and AHMvdHvM) using a maximum of 15 criteria (see online supplementary table S1), which were based on previous systematic reviews in the field of musculoskeletal disorders 6 7. The criteria were adapted for our research question of symptom duration.…”

The effects of implementing a point-of-care electronic template to prompt routine anxiety and depression screening in patients consulting for osteoarthritis (the Primary Care Osteoarthritis Trial): A cluster randomised trial in primary care

“…Patients with painful, disabling OA constitute a high-risk group for distress, anxiety, and depressive disorders [3–5]. While many of the factors associated with the future course of OA are not modifiable (e.g., age, sex, symptom duration, and severity of underlying structural changes to the joint [6–9]), comorbid depression and anxiety are adversely related to future course [10,11], treatment response [12], and healthcare use [13], and show a reciprocal relationship with pain and functional outcomes [12,14,15]. Evidence from a single clinical trial of a collaborative care approach using psychological therapies and medication management for previously diagnosed major depressive disorder in patients with self-reported OA supports the principle of managing comorbid depression as a means of modifying general and OA-specific clinical outcomes, having shown beneficial effects of depression management on pain intensity, pain-related function, and quality of life sustained to 12 mo [16–18].…”

Improved Hand Function, Self‐Rated Health, and Decreased Activity Limitations: Results After a Two‐Month Hand Osteoarthritis Group Intervention

“…OA often affects finger joints, knee, hip, and spine, and the most common type is OA of the hand. Hand OA affects both women and men but is more common among women age >50 years, increasing with age thereafter , and there is also a strong genetic risk factor . Hand OA often presents in the distal interphalangeal (DIP) joints (54%), followed by the carpometacarpal (CMC) joint of the thumb (20%), proximal interphalangeal (PIP) joints (8%), and metacarpophalangeal (MCP) joints .…”