PICASSO
Treatment of painful inflammatory carpometacarpal-1 osteoarthritis with intra-articular steroids, saltwater or occupational therapy
Project Manager
Postdoc
Postdoc
ABOUT THE PROJECT
Osteoarthritis of the thumb metacarpophalangeal joint (CMC-1) can cause pain and poor hand function. Unfortunately, treatment options for this patient group are limited. All patients should be offered non-pharmacological measures such as hand exercises, but few receive this type of treatment. There is also limited knowledge about the effect of cortisone on this patient group.
The main goal of the project is to see whether cortisone injections are better than saline injections, and whether non-drug treatment is as good as cortisone.
The study will have direct consequences for current treatment, as by comparing different treatment alternatives, it will contribute knowledge about which alternatives are both effective and safe.
WHO CAN JOIN?
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.
WHAT DOES THE STUDY INVOLVE?
The study is being conducted in two phases:
Phase 1 is a randomized controlled trial with a duration of 6 months. The patients who participate will be randomized into three different groups, where group 1 receives a cortisone injection in the CMC-1 joint, group 2 receives a saline injection (placebo) in the CMC-1 joint, and group 3 receives non-drug treatment with hand training and a support splint. Those who receive the injection can repeat it after 3 months, but will not be told whether they receive cortisone or saline. The main objective of the study is to look at the change in pain after 4 weeks. The secondary objectives are to look at the change in pain and hand function after three months and two years, and MRI-defined inflammation after 4 weeks and the degree of osteoarthritis and subluxation after 2 years.
Phase 2 is an open-label study lasting 18 months. Here, all participating patients can receive cortisone injections if the treating rheumatologist finds it appropriate. Here, the researchers will also study whether repeated injections can have a harmful effect on the joint.
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