TNF blockers did not relieve chronic hand pain due to OA

French investigators determined in a double-blind study that anti-tumor necrosis factor (TNF) drugs are ineffective for relieving pain in patients who have severe hand osteoarthritis (OA).

Using the anti-TNF drug adalimumab, investigators injected 38 patients in the active group with the drug and injected 35 patients with a placebo. They set a 50% improvement in OA pain relief as a successful treatment outcome, according to the abstract. The patients were monitored for 26 weeks after treatment.

“Our research found that two injections of anti-TNF failed to improve severe painful hand OA,” Xavier Chevalier, MD, PhD, head of the department of rheumatology at Hospital Henri Mondor, in Paris France, stated in a press release. “New trials are needed to find the right target in painful hand OA because this is a disease where we have no real therapy and the patients develop the feeling of a neglected disease,” he stated.

However, 6 weeks after the injections were given there was a 2.5 point difference in mean Visual Analog Scale pain scores between the two groups of patient, which was not significant.

There was, however, a difference in the number of swollen joints between baseline and the 26-week follow-up with fewer swollen joints in the adalimumab group, but the analgesic use proved similar in both groups, according to the abstract.

Patients in the adalimumab group show 35.1% pain improvement while the placebo group showed 27.3% pain improvement, but neither group attained the primary outcome of 50% improvement in pain set by Chevalier and colleagues.

All patients met the American College of Rheumatology criteria for severe hand pain and did not respond to painkillers. They received injections at baseline and two weeks into the trial, according to the abstract.

Reference:

Chevalier X. Paper #2472. Presented at: American College of Rheumatology Annual Meeting. Nov. 10-14, 2012; Washington D.C.

Disclosure: Chevalier has no relevant financial disclosures.