Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials
Background/Aims Conventional disease-modifying anti-rheumatic drugs have been trialed in osteoarthritis (OA). Hydroxychloroquine (HCQ), which has shown its effectiveness in rheumatoid arthritis, has been trialed for the treatment of OA; however, its efficacy and safety remain unclear. This systemati...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2022-01-01
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| Series: | The Korean Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://kjim.org/upload/pdf/kjim-2020-605.pdf |
| _version_ | 1818942758614728704 |
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| author | Ambrish Singh Anirudh Kotlo Zhiqiang Wang Thusharika Dissanayaka Siddharth Das Benny Antony |
| author_facet | Ambrish Singh Anirudh Kotlo Zhiqiang Wang Thusharika Dissanayaka Siddharth Das Benny Antony |
| author_sort | Ambrish Singh |
| collection | DOAJ |
| description | Background/Aims Conventional disease-modifying anti-rheumatic drugs have been trialed in osteoarthritis (OA). Hydroxychloroquine (HCQ), which has shown its effectiveness in rheumatoid arthritis, has been trialed for the treatment of OA; however, its efficacy and safety remain unclear. This systematic review and meta-analysis evaluate efficacy and safety of HCQ for the treatment of OA. Methods MEDLINE, EMBASE, and Cochrane Central were searched from inception through June 2020. Two reviewers independently screened for randomized controlled trials (RCTs) comparing HCQ with placebo or other active-comparators for the treatment of knee, hand, or hip OA, extracted data, and performed Cochrane risk of bias assessments. Results Six RCTs, four in hand OA, two in knee OA, consisting of 842 patients (436 in HCQ arm, 406 in control arm) were included. RCTs were conducted between 2012 and 2020, one each at UK, Netherlands, Germany, Italy, Iran, and Egypt; follow-up period ranged 24 to 52 weeks. High-quality evidence showed no clinically important pain reduction with HCQ compared to placebo/active-control in hand OA (standardized mean difference [SMD], 0.14; 95% confidence interval [CI], –0.20 to 0.48). Effect on pain reduction in knee and hand OA was small and non-significant (SMD, –0.09; 95% CI, –0.44 to 0.25). High-quality evidence showed no improvement in dysfunction with HCQ compared to placebo in hand OA patients (SMD, 0.08; 95% CI, –0.23 to 0.40). Effect on dysfunction improvement in knee and hand OA was modest and statistically non-significant (SMD, –0.20; 95% CI,–0.57 to 0.18). No improvement in quality of life was observed in hand OA. Conclusions HCQ has no benefit in reducing pain and improving physical function in hand or knee OA patients. |
| first_indexed | 2024-12-20T07:16:31Z |
| format | Article |
| id | doaj.art-0fee492e5c4a48e7b8fd86e46fe62406 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-12-20T07:16:31Z |
| publishDate | 2022-01-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-0fee492e5c4a48e7b8fd86e46fe624062022-12-21T19:48:46ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482022-01-0137121022110.3904/kjim.2020.605170530Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trialsAmbrish Singh0Anirudh Kotlo1Zhiqiang Wang2Thusharika Dissanayaka3Siddharth Das4Benny Antony5 Department of Musculoskeletal Health and Disease, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia St. Lawrence College, Vancouver, BC, Canada Department of Musculoskeletal Health and Disease, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia Department of Physiotherapy, Monash University, Frankston, Australia Department of Rheumatology, Era’s University, Lucknow, India Department of Musculoskeletal Health and Disease, Menzies Institute for Medical Research, University of Tasmania, Hobart, AustraliaBackground/Aims Conventional disease-modifying anti-rheumatic drugs have been trialed in osteoarthritis (OA). Hydroxychloroquine (HCQ), which has shown its effectiveness in rheumatoid arthritis, has been trialed for the treatment of OA; however, its efficacy and safety remain unclear. This systematic review and meta-analysis evaluate efficacy and safety of HCQ for the treatment of OA. Methods MEDLINE, EMBASE, and Cochrane Central were searched from inception through June 2020. Two reviewers independently screened for randomized controlled trials (RCTs) comparing HCQ with placebo or other active-comparators for the treatment of knee, hand, or hip OA, extracted data, and performed Cochrane risk of bias assessments. Results Six RCTs, four in hand OA, two in knee OA, consisting of 842 patients (436 in HCQ arm, 406 in control arm) were included. RCTs were conducted between 2012 and 2020, one each at UK, Netherlands, Germany, Italy, Iran, and Egypt; follow-up period ranged 24 to 52 weeks. High-quality evidence showed no clinically important pain reduction with HCQ compared to placebo/active-control in hand OA (standardized mean difference [SMD], 0.14; 95% confidence interval [CI], –0.20 to 0.48). Effect on pain reduction in knee and hand OA was small and non-significant (SMD, –0.09; 95% CI, –0.44 to 0.25). High-quality evidence showed no improvement in dysfunction with HCQ compared to placebo in hand OA patients (SMD, 0.08; 95% CI, –0.23 to 0.40). Effect on dysfunction improvement in knee and hand OA was modest and statistically non-significant (SMD, –0.20; 95% CI,–0.57 to 0.18). No improvement in quality of life was observed in hand OA. Conclusions HCQ has no benefit in reducing pain and improving physical function in hand or knee OA patients.http://kjim.org/upload/pdf/kjim-2020-605.pdfhydroxychloroquineosteoarthritissystematic reviewmeta-analysisrandomized controlled trial |
| spellingShingle | Ambrish Singh Anirudh Kotlo Zhiqiang Wang Thusharika Dissanayaka Siddharth Das Benny Antony Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials The Korean Journal of Internal Medicine hydroxychloroquine osteoarthritis systematic review meta-analysis randomized controlled trial |
| title | Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | efficacy and safety of hydroxychloroquine in osteoarthritis a systematic review and meta analysis of randomized controlled trials |
| topic | hydroxychloroquine osteoarthritis systematic review meta-analysis randomized controlled trial |
| url | http://kjim.org/upload/pdf/kjim-2020-605.pdf |
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