TNF inhibitors confer benefits for hand osteoarthritis progression
Treatment with tumour necrosis factor inhibitors (TNFi) appears to reduce the risk of radiographic hand osteoarthritis (OA) progression in distal interphalangeal (DIP) joints but not in proximal interphalangeal (PIP) joints for up to 10 years, according to a study.
Researchers examined the radiographs of 262 rheumatoid arthritis (RA) patients (mean age 52 years; 66 percent female) participating in the BeSt study. Radiographs were scored for osteophytes in DIP/PIP joints according to the Osteoarthritis Research Society International atlas (0–3; summed score 0–54) and according to the Kellgren–Lawrence (KL) score (0–4; summed score 0–72) at baseline and at 10-year follow-up.
TNFi treatment was assessed on visits every 3 months and evaluated in relation to hand OA using generalized linear models and generalized estimating equations.
Of the patients, 58 percent received treatment with TNFi, with a median duration of 42 months. At baseline, there were 143 (55 percent) who had hand OA in any IP joint based on the Osteoarthritis Research Society International osteophyte score.
TNFi treatment duration did not influence incidental hand OA on the patient level. However, every month of TNFi treatment reduced the risk (RR) of hand OA progression in DIP joints (relative risk [RR], 0.987; 95 percent CI, 0.978–0.996) but not in PIP joints.
On the joint level, the effect of TNFi treatment on hand OA progression was likewise evident in DIP joints (RR, 0.996; 0.991–1.000) but not in PIP joints. Results for the KL score did not differ with those for osteophyte score.
Although the effect sizes are small, the findings of the present study provide evidence for the influence of tumour necrosis factor-alpha in hand OA pathogenesis, researchers said.