Haugen Ida K, Gløersen Marthe, Mulrooney Elisabeth, Mathiessen Alexander
I.K. Haugen, MD, PhD, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
M. Gløersen, MD, PhD, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
J Rheumatol. 2025 Jun 15. doi: 10.3899/jrheum.2025-0206.
Historically, osteoarthritis (OA) was considered a noninflammatory joint disease, distinct from systemic inflammatory diseases such as rheumatoid arthritis and psoriatic arthritis. However, observational studies on hand OA have shown that synovitis is common and is associated with both pain and disease progression. Hence, targeting synovitis in hand OA could provide clinical benefits in terms of symptom relief and disease modification. Conflicting results have been found in several previous studies that have tested the efficacy of various antiinflammatory treatments, including oral and topical nonsteroidal antiinflammatory drugs (NSAIDs), oral and intraarticular corticosteroids, colchicine, and synthetic and biologic disease-modifying antirheumatic drugs (DMARDs). To date, prednisolone and methotrexate have shown the most promising results. Several ongoing studies, especially those investigating intraarticular antiinflammatory therapies, are expected to provide valuable insights for clinical practice.
从历史上看，骨关节炎（OA）被认为是一种非炎性关节疾病，与类风湿关节炎和银屑病关节炎等全身性炎性疾病不同。然而，对手部骨关节炎的观察性研究表明，滑膜炎很常见，并且与疼痛和疾病进展都有关联。因此，针对手部骨关节炎中的滑膜炎进行治疗，在缓解症状和改变病情方面可能会带来临床益处。在之前的几项研究中，测试了包括口服和外用非甾体抗炎药（NSAIDs）、口服和关节内注射皮质类固醇、秋水仙碱以及合成和生物性改善病情抗风湿药（DMARDs）在内的各种抗炎治疗的疗效，结果相互矛盾。迄今为止，泼尼松龙和甲氨蝶呤显示出最有前景的结果。几项正在进行的研究，尤其是那些调查关节内抗炎疗法的研究，有望为临床实践提供有价值的见解。
