TY - JOUR
T1 - Patterns and natural history of hand pain in individuals with symptomatic hand osteoarthritis in a prospective cohort study
T2 - A post-hoc analysis of a randomised controlled trial
AU - Estee, Mahnuma Mahfuz
AU - Wang, Yuanyuan
AU - Lim, Yuan Z.
AU - Wluka, Anita E.
AU - Cicuttini, Flavia M.
N1 - Funding Information:
Mahnuma M Estee is a recipient of Bangabandhu Science and technology Fellowship from Ministry of Science and Technology, Government of the People's Republic of Bangladesh for her PhD. Yuan Z Lim is the recipient of NHMRC Clinical Postgraduate Scholarship (APP1133903) and Royal Australasian College of Physicians Woolcock Scholarship. Anita E Wluka is the recipient of the Royal Australian College of Physicians Fellows Career Development Fellowship. Flavia M Cicuttini is the recipient of National Health and Medical Research Council ( NHMRC ) Investigator Grant (APP1194829). The funding bodies had no role in the study design and conduct of the study; collection, analysis and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
The findings of this study add to knowledge about the characteristics and natural history of three common hand pain phenotypes (both CMC and IP, CMC only and IP only). Although the demographics of these three groups were similar, those with both the CMC and IP pain had higher clinical burden at baseline, with a trend for worse prognosis of hand pain and function over 6 weeks compared with those with the CMC pain only or the IP pain only. This may in part be explained by the greater number of joints involved, the longer duration of the disease, and presence of higher neuropathic-like pain in those with both the CMC and IP pain. The potential effect of neuropathic-like pain is supported by our findings of a lower prevalence of moderate to severe radiological OA (KL grade 3–4) and higher neuropathic-like pain in participants with both the CMC and IP pain, which is similar to previous findings [10,23].Mahnuma M Estee is a recipient of Bangabandhu Science and technology Fellowship from Ministry of Science and Technology, Government of the People's Republic of Bangladesh for her PhD. Yuan Z Lim is the recipient of NHMRC Clinical Postgraduate Scholarship (APP1133903) and Royal Australasian College of Physicians Woolcock Scholarship. Anita E Wluka is the recipient of the Royal Australian College of Physicians Fellows Career Development Fellowship. Flavia M Cicuttini is the recipient of National Health and Medical Research Council (NHMRC) Investigator Grant (APP1194829). The funding bodies had no role in the study design and conduct of the study; collection, analysis and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/12
Y1 - 2023/12
N2 - Objective: To investigate the variation in the distribution and the natural history of hand pain over 6 weeks in individuals with symptomatic hand osteoarthritis. Design: Patient-reported outcome data were collected at baseline and weekly for 6 weeks from community-based participants enrolled in a randomised controlled trial. Participants were grouped based on location of significant pain (Visual Analogue Scale, VAS≥40/100 mm) (both carpometacarpal (CMC) and interphalangeal (IP), CMC only, and IP only). Results: At baseline, of the 106 participants, 55(51.9 %) had pain in both CMC and IP joints, 28(26.4 %) in IP joints only, and 16(15.1 %) in CMC joint only. Those with CMC and IP pain had significantly higher VAS pain [68.1 (2.6) vs 59.3 (3.5) vs 51.2 (4.7)]; Australian Canadian Osteoarthritis Hand Index, (AUSCAN) pain [290.1 (15.7) vs 225.3 (21.2) vs 237.9 (28.4)], stiffness [57.1 (3.7) vs 44.6 (5.0) vs 32.2 (6.7)] and functional limitation [527.5 (30.9) vs 356.0 (41.7) vs 433.3 (55.7)]; and pain sensitization [PainDETECT score 11.1 (1.1) vs 8.1 (1.8) vs 5.8 (1.9)] compared to those with IP or CMC only pain, respectively. All groups showed improvement in outcomes over 6 weeks without significant inter-group differences. Conclusion: In a population with significant hand pain, pain in both CMC and IP joints was most common and identified a more severe phenotype than pain in IP or CMC only with higher pain, more functional limitation and pain sensitization. These data have the potential to inform clinical management of patients with hand pain and patient selection in clinical trials.
AB - Objective: To investigate the variation in the distribution and the natural history of hand pain over 6 weeks in individuals with symptomatic hand osteoarthritis. Design: Patient-reported outcome data were collected at baseline and weekly for 6 weeks from community-based participants enrolled in a randomised controlled trial. Participants were grouped based on location of significant pain (Visual Analogue Scale, VAS≥40/100 mm) (both carpometacarpal (CMC) and interphalangeal (IP), CMC only, and IP only). Results: At baseline, of the 106 participants, 55(51.9 %) had pain in both CMC and IP joints, 28(26.4 %) in IP joints only, and 16(15.1 %) in CMC joint only. Those with CMC and IP pain had significantly higher VAS pain [68.1 (2.6) vs 59.3 (3.5) vs 51.2 (4.7)]; Australian Canadian Osteoarthritis Hand Index, (AUSCAN) pain [290.1 (15.7) vs 225.3 (21.2) vs 237.9 (28.4)], stiffness [57.1 (3.7) vs 44.6 (5.0) vs 32.2 (6.7)] and functional limitation [527.5 (30.9) vs 356.0 (41.7) vs 433.3 (55.7)]; and pain sensitization [PainDETECT score 11.1 (1.1) vs 8.1 (1.8) vs 5.8 (1.9)] compared to those with IP or CMC only pain, respectively. All groups showed improvement in outcomes over 6 weeks without significant inter-group differences. Conclusion: In a population with significant hand pain, pain in both CMC and IP joints was most common and identified a more severe phenotype than pain in IP or CMC only with higher pain, more functional limitation and pain sensitization. These data have the potential to inform clinical management of patients with hand pain and patient selection in clinical trials.
KW - Hand osteoarthritis
KW - Hand pain
KW - Natural history
KW - Phenotype
UR - http://www.scopus.com/inward/record.url?scp=85174457431&partnerID=8YFLogxK
U2 - 10.1016/j.ocarto.2023.100413
DO - 10.1016/j.ocarto.2023.100413
M3 - Article
C2 - 37920673
AN - SCOPUS:85174457431
SN - 2665-9131
VL - 5
JO - Osteoarthritis and Cartilage Open
JF - Osteoarthritis and Cartilage Open
IS - 4
M1 - 100413
ER -