Painful Inflammatory Carpometacarpal-1 OsteoArthritis Treatment with Intraarticular Steroids, Saline or Occupational therapy

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About the project

Osteoarthritis of the root joint of the thumb (CMC-1) can cause pain and poor hand function. Unfortunately, treatment options for this group of patients are limited. All patients should be offered non-pharmacological measures such as hand training, but few patients receive this type of treatment. There is also limited knowledge about the effect of cortisone in this patient group.

The main aim of the project is to see if cortisone injections are better than saline injections and if non-drug treatment is as good as cortisone.

The study will have a direct impact on current treatment by comparing different treatment options and providing knowledge about which options are both effective and safe.

Who can participate?

Recruitment is ongoing.

Adults diagnosed with osteoarthritis of the thumb root joint will be eligible for inclusion in the study. Patients will be recruited from six hospitals from all four health regions in Norway.

Project arrangement

The study is conducted in two phases:

Phase 1 is a randomized controlled trial with a duration of 6 months. Participating patients will be randomized into three different groups where group 1 will receive a cortisone injection into the CMC-1 joint, group 2 will receive a saline injection (placebo) into the CMC-1 joint, and group 3 will receive non-pharmacological treatment with hand training and a support splint. Those who receive the injection can repeat it after 3 months, but are not told whether they receive cortisone or saline. The main aim of the study is to look at the change in pain after 4 weeks. Sub-objectives are to look at change in pain and hand function at 3 months and 2 years, and MRI-defined inflammation at 4 weeks and degree of osteoarthritis and subluxation at 2 years.

Phase 2 is an open-label study lasting 18 months. Here, all participating patients can receive cortisone injections if the treating rheumatologist deems it appropriate. The researchers will also study whether repeated injections can be harmful to the joint.


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