Sensitivity to change of the functional index for hand osteoarthritis

Background: The functional index for hand osteoarthritis (FIHOA), a 10-item investigator-administered questionnaire, was validated in 1995. It is rele vant, reliable and has good external and internal validities. Objective: To assess the sensitivity to change over time of the FIHOA. Patients/Methods: Patients: symptomatic [visual analog scale (VAS) greater than or equal to 30 mm, FIHOA greater than or equal to5] hand OA patients [ American College of Rheumatology (ACR) criteria, greater than or equal to2 radiologically affected joints] were included in a 6-month randomized, doub le-blind, placebo-controlled trial. Recorded parameters: Pain on VAS, FIHOA score, morning stiffness duration, grip strength. Statistical analysis: me an standardized response (MSR=Delta DO-M6/S.D. of Delta) was calculated for each parameter in an intention-to-treat (ITT) population before breaking t he randomization code. Results: 239 women, 22 men, mean age 61+/-7.5 years were recruited. Charact eristics of HOA: 88% of patients were right-handed, 48% had a family histor y of hand OA. The location of OA was the first trapezo-metacarpal (TMC) joi nt (62%), proximal interphalangeal (PIP) joint (47.5%), distal interphalang eal (DIP) joint (67.6%). The mean number of painful flares (previous 12 mon ths) was 4.4, that of painful joints was 3.7, that of nodal joints in the r ight hand 3.1, and that of radiologically affected joints was 4.4. Baseline symptomatic severity assessment gave pain on VAS=54.4+/-14 mm, FIHOA score =10.4+/-3.7, morning stiffness duration=20+/-27.6 min and grip strength=59. 3+/-21.2 mm Hg. The MSR value was 0.58 for the FIHOA and 0.87 for pain on V AS. Conclusion: The sensitivity to change of the FIHOA over 6 months is high, b ut inferior to that of pain on VAS in this trial. (C) 2000 OsteoArthritis R esearch Society International.