Patients with erosive osteoarthritis (OA) have more functional impairment and significantly more pain in the hands than patients with controlled inflammatory arthritis and patients with nonerosive OA. The main contributing factors are radiographic damage, number of tender joints, reduction in grip strength, and female sex.
Wittoek and colleagues studied 270 patients with hand OA and a group of patients with inflammatory arthritis (rheumatoid arthritis or psoriatic arthritis) who had low disease activity or disease in remission. Levels of functional impairment were measured by the Functional Index for Hand OA (FIHOA) and Australian/Canadian OA Hand Index (AUSCAN).
Patients with erosive OA had worse functional outcome and pain scores than patients with controlled inflammatory arthritis or nonerosive OA, even though a higher percentage of them were taking analgesics. After correction for potential confounders, pain scores remained significantly higher in patients with erosive OA. There was a trend in FIHOA and AUSCAN function scores toward more disability in patients with erosive OA. The presence of radiographic OA of the carpometacarpal joints did not influence functional outcome in the patients with erosive OA.
The authors noted that their study results highlight erosive OA's significant clinical burden and suggest a need for new treatment strategies.