Hand OA Needs Some Pain Relief

Humira for osteoarthritis of the hand did not lower pain

(RxWiki News) When traditional drugs fail to reduce the pain of osteoarthritis, doctors may put patients on anti-tumor necrosis factor (anti-TNF) medications. But at least one anti-TNF drug may not relieve pain either.

Patients with hand osteoarthritis did not experience less pain after taking Humira (adalimumab), according to a recent study.

These researchers said the significant difference was a reduction in the number of swollen joints in patients taking Humira.

"Tell a doctor if your Rx is not working well."

Painkillers and non-steroidal anti-inflammatory drugs (NSAIDs) are often the first drugs used to treat osteoarthritis. When patients do not respond to these drugs, doctors may prescribe anti-TNF drugs, which include Humira.

Xavier Chevalier, MD, PhD, of Hopital Henri Mondor in France, and colleagues wanted to see if patients with hand osteoarthritis who did not respond to painkillers or NSAIDs experienced less pain after taking Humira.

To measure pain, the researchers used a 100 mm visual analogue scale (VAS). To use the VAS, a patient marks a point on the line that most represents their pain. A zero on the scale indicates no pain while 100 mm indicates very severe pain.

At the beginning of the study, the mean (middle) pain level was 65.4 mm.

After 6 weeks of treatment, there was only a 2.5 mm difference in the average change in pain score between patients treated with Humira and those treated with placebo.

The researchers measured the success of treatment as a 50 percent improvement in pain.

After 6 weeks, neither group achieved this goal. There was 35.1 percent improvement among patients taking Humira and 27.3 percent improvement among those taking placebo.

"Our research found that two injections of anti-TNF (Humira) failed to improve severe painful hand osteoarthritis," said Dr. Chevalier.

"New trials are needed to find the right target in painful hand osteoarthritis because this is a disease where we have no real therapy and the patients develop the feeling of a neglected disease," he said.

The study was small, with only 78 patients involved in the analysis. Of these, 41 received Humira and 37 received placebo. The research was funded by Inserm pro A and a grant from Abbott Laboratory, the manufacturer of Humira.

The authors disclosed no conflicts of interest. The study was presented at the American College of Rheumatology's Annual Meeting. As such, it has yet to be reviewed by a body of peers and published in a scientific journal.

Review Date: 
November 14, 2012