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A randomised double-blind placebo-controlled crossover trial of Adalimumab for erosive hand OsteoaRthritis - The HUMOR trial

A randomised double-blind placebo-controlled crossover trial of Adalimumab for erosive hand OsteoaRthritis - The HUMOR trial A randomised double-blind placebo-controlled crossover trial of Adalimumab for erosive hand OsteoaRthritis - The HUMOR trial
A randomised double-blind placebo-controlled crossover trial of Adalimumab for erosive hand OsteoaRthritis - The HUMOR trial A randomised double-blind placebo-controlled crossover trial of Adalimumab for erosive hand OsteoaRthritis - The HUMOR trial

To evaluate the effectiveness of Adalimumab among individuals with erosive hand osteoarthritis (OA). 

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Key take away

An erosive hand osteoarthritis is a form of hand osteoarthritis. The phase of the normal process or separate entity and remains debated. It is defined by radiographic erosions with a central subchondral bone collapse. Therefore, the outcomes of this research demonstrated that the adalimumab (40 mg subcutaneous injections) did not show any effect on patients with erosive hand OA with MRI-detected synovitis as compared to placebo after 12 weeks.

Background

To evaluate the effectiveness of Adalimumab among individuals with erosive hand osteoarthritis (OA). 

Method

The individuals met the American College of Rheumatology (ACR) criteria for hand OA, with >30 min morning stiffness,  ≥1 erosive joint on X-ray with synovitis, and >50 on 100 mm visual analogue scale scores with age of  >50 years old were selected for the study. Two groups were formed; one received 40 mg subcutaneous injections of Adalimumab every other week, and other group received identical placebo injections for 12 weeks, succeeded by an 8-week washout and later crossed over medication groups for another 12 weeks. Change in VAS hand pain over 12 weeks was taken as the primary endpoint.  Function and stiffness subscales from baseline to 4, 8 and 12 weeks, change in Australian/Canadian Hand OA Index (AUSCAN) pain, change in VAS from baseline to 4 and eight weeks, a change in MRI-detected synovitis and bone marrow lesions (BMLs) from baseline to 12 weeks were taken as study's secondary endpoints. 

Result

A total of 43 subjects categorised either group one or group two. No change was seen between the groups regarding primary endpoint at 12 weeks. The adjusted treatment effect found to be -0.7 mm. Secondary endpoints also exhibited no statistically significant differences.

Conclusion

As compared to placebo, Adalimumab did not present any impact on synovitis, pain, or BMLs among patients with erosive hand OA with MRI-detected synovitis.

Source:

Osteoarthritis Cartilage. 2018 Feb 27.

Article:

A randomised double-blind placebo-controlled crossover trial of HUMira (adalimumab) for erosive hand OsteoaRthritis - The HUMOR trial

Authors:

Lesley M. Arnold et al.

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