THERAPEUTIC TRIALS IN DIGITAL OSTEOARTHRITIS - A CRITICAL-REVIEW

Although common, hand osteoarthritis is controversial and rarely used as a model for clinical trials in osteoarthritis. We found only 13 the rapeutic trials conducted in digital or trapeziometacarpal osteoarthri tis between 1983 and 1994. Eleven of these trials were published. Seve n were on nonsteroidal antiinflammatory drugs given either per os (two trials, meclofenamate and ibuprofen) or percutaneously (one trial eac h on etofenamate, ibuprofen, and ketoprofen gel, and two trials on nif lumic acid gel), three were on symptomatic slow-acting drugs (glycosam inoglycanes in two trials and chondroitin sulfate in one), and three w ere on miscellaneous agents (the muscle relaxant idrocilamide, as a ge l; the antisubstance P agent capsaicin, also as a gel; and a spa treat ment). We have reviewed the methodology and findings of these trials w ith the goal of determining the optimal approach to realize better sta ndardized trials in the next future for identifying symptomatic slow-a cting drugs and/or ''chondroprotective'' agents with beneficial effect s in digital osteoarthritis.