Efficacy and safety of corticosteroid in the treatment of hand osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To assess the efficacy and safety of corticosteroid therapy including oral corticosteroid and intra-articular corticosteroid in patients with hand osteoarthritis (OA), to provide treatment recommendations, and provide data-driven suggestions for future studies. METHODS: A systematic review of the literature was performed from inception to February 19, 2020, and the study was conducted on February 20, 2020. All controlled trials in Ovid MEDLINE, EMBASE, and Cochrane library reporting the efficacy on pain, functional recovery, and adverse events of corticosteroids in hand osteoarthritis were selected. The primary outcome was pain assessed on a visual analogue scale (VAS) lasting for up to 24 weeks. Pooled mean difference (MD) for continuous variable and risk ratio (RR) for dichotomous variable, with 95% confidence intervals (CIs), was assessed by a random effects model. RESULTS: Overall, seven trials totaling 511 participants were included in this study. The pooled analysis showed a significant difference in VAS pain (MD, - 5.75; 95% CI, - 10.08 to - 1.42, I2 = 40%). No significant differences were observed in any of the adverse events. CONCLUSION: Our data suggest corticosteroids in hand OA might improve local pain and promote functional recovery. However, since these findings were based on only 7 studies and due to significant heterogeneity across the included studies, these findings need to be confirmed by future clinical trials with a higher number of patients. KEY POINTS: • Current evidences of glucocorticoids for the management of hand osteoarthritis (OA) were insufficient and more evidences were needed. • The results of the present meta-analysis revealed corticosteroids in hand OA might improve local pain and promote functional recovery. • These findings need to be confirmed by future clinical trials with a higher number of patients.