rheumatiod and psoriatic arthritis of the wirst wrist arthritis
Conditions
Interventions
This study will randomize between arthroscopic synovectomy of the wrist
combined with deposition of intra-articular corticosteroids (DIACS) and
intra-articular corticosteroid injection (IACSI) of th
Sponsors
Maasstadziekenhuis
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Inclusion criteria: - Male and female patients that are 18 years or older - Patients are diagnosed with rheumatoid arthritis according to the revised 2010 ACR/EULAR Rheumatoid Arthritis Classification Criteria or with psoriatic arthritis according to the CASPAR criteria - Patients are experiencing an exacerbation defined as an increase in DAS28 > 1.2 or > 0.6 if DAS28 >= 3.2 compared to last DAS28 measurement (maximum 6 months before), or an exacerbation clinically diagnosed by a rheumatologist. - Wrist arthritis, that is clinically diagnosed, is the predominant symptom - Patients with an exacerbation, either under cDMARD treatment or no treatment specified as: • Patients with an exacerbation and are stopped with cDMARD treatment in the past due to side-effects or no effect from cDMARD treatment. • Patients with an exacerbation and can*t start cDMARD treatment due to contra-indications for cDMARD treatment. • Patients with a mono- or oligoarthritis as an exacerbation and have stopped cDMARD treatment in the past due to disease in remission. First choice of treatment in case of mono- or oligoarthritis can be local treatment before restart systemic cDMARD treatment.
Exclusion criteria
Exclusion criteria: - Current treatment or treatment within the last 12 months with biological (b)DMARDs - Current inflammatory joint disease other than RA or PsA (e.g., gout, reactive arthritis, Lyme disease) - Subjects who are pregnant or intend to become pregnant during the study - Intra-articular corticosteroids injection in the wrist in the last 3 months. - Previous wrist surgery - Severe osteoarthritis with malformations of the wrist - Congenital abnormalities of wrist function or motion - Patients with arthritis in both wrists can only participate in the study with one wrist
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Patient-Rated Wrist Evaluation (PRWE), 3 months after intervention | — |
Secondary
| Measure | Time frame |
|---|---|
| - DAS28 score - Resolution of synovitis measured with ultrasound (using the EULAR-OMERACT combined scoring system) - Wrist damage measured with plain wrist radiographs - Range of motion (ROM) and grip strength of the wrist - Quality of life measured with the EQ-5D - Cost-effectiveness analysis calculated with the EQ-5D, iMCQ and iPCQ | — |
Countries
Netherlands
Outcome results
None listed