Osteoarthritis Finger, Osteoarthritis Hand
Conditions
Brief summary
The study aims to compare oral colchicine 0.5 mg administered two times daily for 12 weeks with placebo as a treatment of hand OA symptoms.
Interventions
DRUGColchicine 0.5 MG
The intervention tablets are commercially available Colchicine Tiofarma
DRUGPlacebo
Encapsulated placebo tablets. Placebo is identical to the active intervention.
Sponsors
Henning Bliddal
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age ≥18 years. 2. Hand OA according to the ACR criteria above. 3. Hand OA finger pain: Pain at rest ≥40 mm on VAS (0 to 100 mm range).
Exclusion criteria
Comorbidities 1. Other known medical disease that may affect joints, e.g. RA, gout, PsA 2. Positive anti-cyclic citrullinated peptide (\>10 kU/L) 3. Known cutaneous deposition diseases (e.g. amyloidosis or porphyria). 4. Known blood dyscrasias and coagulation disorders 5. Known malignancy (except successfully treated squamous or basal cell skin carcinoma) 6. Elevated alanine transaminase (\>45 U/L females, \>70 U/L for males) 7. Creatinine clearance ≤60 ml/min 8. Elevated creatine kinase (\>210 U/L females, \>280 U/L for males) 9. Known allergies towards the interventions 10. Drug or alcohol abuse in the last year 11. Generalised pain syndromes such as fibromyalgia 12. Current reflux 13. Current or recurrent diarrhoeal illnesses 14. Current abdominal pain 15. Known peripheral neuropathies 16. Any other condition or impairment that, in the opinion of the investigator, makes a potential participant unsuitable for participation or which obstruct participation, such as e.g. psychiatric disorders. Medical history 17. History of hand surgery within 12 months prior enrolment. 18. History of arthroplasty or arthrodesis in the hand Management strategies 19. Treatment with P-glycoprotein inhibitors and/or cytochrome P450 3A4 (CYP3A4) inhibitors, see section Colchicine safety in drug-drug interactions and table 7. If potential participants have been treated with these pharmaceuticals previously, treatment must be terminated 5 half-lifes before initiation of study drug. 20. Use of systemic corticosteroids equivalent of ≥ 7.5 mg prednisolone daily within 3 months. 21. Participation in experimental device or experimental drug study 3 months prior to enrolment. 22. Intra-articular treatments or aspirations of any kind of any joint in the hands 3 months before inclusion 23. Intra-articular corticosteroids into any joint 1 months before inclusion 24. Current use of synthetic or non-synthetic opioids 25. Scheduled surgery during study participation 26. Planning to start other treatment for hand OA in the study participation period. Reproductive system 27. Pregnancy. 28. Planned pregnancy within the study period, 3 months after end of study treatment for female fertile participant and 6 months after end of study treatment for male participant. 29. Insufficient anti-conception therapy for female fertile participants within the study period and 3 months after end of study treatment. Sufficient anti-conception therapy consists of intra-uterine device (coil),hormonal anti-conception (birth control pills, implant, intra-uterine system, dermal patch, vaginal ring, or injections) or sexual abstinence Female participants are considered infertile if they are postmenopausal or if they have undergone surgical sterilisation (bilateral salpingectomy, hysterectomy or bilateral oophorectomy). Postmenopausal state is defined as no menses for 12 months without alternative medical cause before inclusion in the study. Menopause state will be confirmed by measurement of follicle stimulating hormone. 30. Insufficient anti-conception therapy for male participants within the study period and 6 months after end of study treatment. Sufficient anti-conception therapy consists of condom or sexual abstinence. Male participants are considered sterile if they have undergone surgical sterilisation (vasectomy). 31. Breast-feeding A target hand will be selected for outcome assessment once individual fulfills in- and exclusions criterias. Selection of the target hand will adhere to the following, with advancement to next step if unable to choose target hand based on the given criteria. 1. The hand with most overall pain, assessed by VAS finger joint pain. 2. The hand with most overall reduced function, assessed by AUSCAN function subscale. 3. The hand with most overall stiffness, assessed by AUSCAN stiffness subscale. 4. The hand with most swollen joints, assessed by physician joint count. 5. The hand with most tender joints, assessed by physician joint count. 6. The hand with highest summed radiographic score, assessed by radiographic scoring of conventional X-ray. 7. If unable to select target hand based on the above criteria, a target hand will be randomly assigned.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Finger pain | Week 12 | To compare the effect of oral colchicine 0.5 mg bid, relative to placebo, on changes in finger joint pain of the target hand from baseline to week 12, in patients with painful hand OA measured on a visual analogue scale spanning from 0 to 100, where 0 equals no symptoms and 100 equals worst imaginable symptoms. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Thumb base pain | Week 12 | To compare the effect of oral colchicine 0.5 mg bid, relative to placebo, from baseline to week 12, in patients with painful hand OA on changes in thumb base pain of the target hand measured on a visual analogue scale spanning from 0 to 100, where 0 equals no symptoms and 100 equals worst imaginable symptoms. |
| Pain hands | Week 12 | To compare the effect of oral colchicine 0.5 mg bid, relative to placebo, from baseline to week 12, in patients with painful hand OA on changes in pain of both hands measured on the Australian/Canadian Hand Index Pain Score spanning from 0 to 500, where higher scores equals worse pain. |
| Joint activity | Week 12 | To compare the effect of oral colchicine 0.5 mg bid, relative to placebo, from baseline to week 12, in patients with painful hand OA on changes in joint activity of the target hand measured on physician tender joint count |
| Function | Week 12 | To compare the effect of oral colchicine 0.5 mg bid, relative to placebo, from baseline to week 12, in patients with painful hand OA on changes in function of both hands measured on the Australian/Canadian Hand Index Function Score spanning from 0 to 900, where higher scores equals worse function. |
| Quality of life measured by European Quality of Life 5 Dimensions | Week 12 | To compare the effect of oral colchicine 0.5 mg bid, relative to placebo, from baseline to week 12, in patients with painful hand OA on changes in quality of life measured on the European Quality of Life 5 Dimensions spanning from -0.624 to 1.000, where higher scores equals better quality of life. |
| Hand strength | Week 12 | To compare the effect of oral colchicine 0.5 mg bid, relative to placebo, from baseline to week 12, in patients with painful hand OA on changes in hand strength of the target hand measured on grippit |
| Number of treatment responders according to OMERACT-OARSI response criteria | Week 12 | The following two conditions is observed at the post-baseline assessment: 1. In either pain (finger pain) or function (function), a high improvement in the subscale, where high improvement in a subscale is achieved if there is both a \> 50% improvement from Baseline and an absolute change from Baseline of \> 20 percent points (0-100 scale), OR 2. Improvement in at least two of the following three: * Improvement in pain (finger pain) defined as \> 20% improvement from Baseline and an absolute change from Baseline of \> 10 points (0-100 scale) * Improvement in function (function) defined as \> 20% improvement from Baseline and an absolute change from Baseline of \> 10 points (0-100 scale) * Improvement in patient's global assessment defined as \> 20% improvement from Baseline and an absolute change from Baseline of \> 10 mm (0-100 scale) |
| Patient global assessment | Week 12 | To compare the effect of oral colchicine 0.5 mg bid, relative to placebo, from baseline to week 12, in patients with painful hand OA on changes in patient global assessment measured on a visual analogue scale spanning from 0 to 100, where 0 equals no symptoms and 100 equals worst imaginable symptoms. |
Countries
Denmark
Outcome results
None listed