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. 2023 Aug 12;5(4):100404.
doi: 10.1016/j.ocarto.2023.100404. eCollection 2023 Dec.

Efficacy of tumor necrosis factor inhibitors in hand osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

Mahnuma Mahfuz Estee  1 , Flavia M Cicuttini  1 , Matthew J Page  1 , Anita E Wluka  1 , Yuanyuan Wang  1
Affiliations

Efficacy of tumor necrosis factor inhibitors in hand osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

Mahnuma Mahfuz Estee et al. Osteoarthr Cartil Open. .

Abstract

Objectives: This study aimed at systematically review the evidence for the efficacy of Tumor Necrosis Factor (TNF) inhibitors on symptoms and structural outcomes in hand osteoarthritis.

Methods: Three databases were searched for randomized controlled trials examining the efficacy of TNF inhibitors in hand osteoarthritis. Two authors extracted data and assessed the risk of bias. The mean difference (MD) was calculated, and a random-effects meta-analysis was performed.

Results: Four studies were identified involving 276 participants. Meta-analysis showed that TNF inhibitors had no effect on pain at 4-6 weeks (MD -0.93, 95%CI -7.41 to 5.55; 2 studies) and 24-26 weeks (MD -3.82, 95%CI -11.46 to 3.83; 2 studies) and no effect on grip strength at 12 months (MD -0.35, 95%CI -1.08 to 0.37; 2 studies). There was limited evidence for the effect of TNF inhibitors on structural outcomes at 12 months. Subgroup analysis from 2 studies showed beneficial effect of TNF inhibitors on reducing the progression of structural outcomes in hand OA patients with signs of inflammation but not in those without inflammation. The certainty of the evidence was low for the effect of TNF inhibitor on pain and moderate for the effect on grip strength.

Conclusion: This study found no effect of TNF inhibitors on clinical outcomes in hand osteoarthritis over the short term (<6 weeks) and within one year, with some evidence for beneficial effect on structural outcomes.

Keywords: Hand osteoarthritis; Meta-analysis; Randomized controlled trials; Systematic review; Tumor necrosis factor inhibitors.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for efficacy of tumor necrosis factor inhibitors on hand osteoarthritis.
Fig. 2
Fig. 2
Random-effects meta-analysis of the mean difference in pain, based on tumor necrosis factor inhibitor or placebo at 4–6 weeks and 24–26 weeks.
Fig. 3
Fig. 3
Random-effects meta-analysis of the mean difference in grip strength, based on tumor necrosis factor inhibitor or placebo at 12 months.
See this image and copyright information in PMC

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