Researchers have developed new classification criteria for hand osteoarthritis with support from the European Alliance of Associations for Rheumatology (EULAR). The new criteria combine self-reported data with radiographic findings and represent a significant advance for all research in the field of hand osteoarthritis.
Ida K. Bos-Haugen has led the work on the new classification criteria for hand osteoarthritis. Photo: Diakonhjemmet Hospital, Kathrine Daniloff
Hand osteoarthritis is a common condition that particularly affects the joints in the fingers and the thumb, leading to pain and stiffness. Despite the condition being very common, there is no disease-modifying treatment for hand osteoarthritis. Now, the international research team has developed new classification criteria that can be used in future research studies and thus promote good research on hand osteoarthritis.
“This is an advance for patients with hand osteoarthritis,” says Ida K. Bos-Haugen, the first author of the study. The new criteria allow us to classify hand osteoarthritis more precisely, both in interventional and observational studies.
Benefits of new criteria
Until now, hand osteoarthritis has been classified using the American College of Rheumatology (ACR) criteria developed over 30 years ago. These have relied on self-reported data and clinical joint examination, which can be difficult to perform reliably, especially in large population studies.
"An advantage of the new criteria is that hand osteoarthritis can be classified using self-reported data and X-ray findings, and does not require a clinical examination," says Haugen. "Another major advantage is that the new criteria allow us to classify osteoarthritis in the finger joints and osteoarthritis in the thumb's root joint separately, as these are two types of osteoarthritis that may require different approaches.".
The development of new criteria
This work was led by senior researcher Ida K. Bos-Haugen at Diakonhjemmet Hospital together with Professor Margreet Kloppenburg (Leiden, Netherlands) and Professor David T. Felson (Boston, USA). Diakonhjemmet Hospital was also well represented on the multidisciplinary expert panel where occupational therapist Merete Hermann-Eriksen and physiotherapist Rikke H. Moe participated.
The new criteria were developed through a three-phase process. In the first phase, researchers identified symptoms and findings that could differentiate hand osteoarthritis from other conditions that cause hand pain. In the second phase, they used a consensus-based decision analysis to assess the relative importance of the criteria from a clinical perspective. In the third phase, the scoring system was refined, cutoffs for disease classification were established, and the new criteria were compared with the existing ACR criteria.
“We now have the ability to classify hand osteoarthritis based on a combination of age, duration of morning stiffness, number of joints with bony deposits and joint space narrowing on X-ray, as well as correspondence between symptoms and X-ray findings,” explains Haugen. Using these criteria, one will identify people who are highly likely to have symptoms in the hands due to hand osteoarthritis, which is precisely what is desired in clinical studies.
The future of hand osteoarthritis research
The new criteria are intended for use in research, not in clinical practice. The goal of the criteria is to contribute to better research on hand osteoarthritis.
– Our work gives hope that we can conduct better studies that will one day lead to better treatment for everyone who suffers from this painful condition, concludes Haugen.
the article: https://ard.bmj.com/content/early/2024/05/31/ard-2023-225073
