Study challenges use of off-label drug to treat osteoarthritis in hands

An off-label drug prescribed to treat osteoarthritis of the hand when conventional medication has failed is ineffective, according to new research.


The study shows there was no benefit in taking hydroxychloroquine to control debilitating pain when compared to a placebo (dummy substance). The first-line treatment for hand osteoarthritis is paracetamol, non-steroidal anti-inflammatory drugs or opioids but some patients experience adverse reactions to them. Doctors have used hydroxychloroquine as an off-label alternative. Prescription drugs are licensed for certain conditions: off-label use means doctors are using them to treat illnesses outside of that designated or authorised list. It is not clear how often doctors use hydroxychloroquine off-label although it is believed to be a common practice.


Lead researcher Dr Sarah Kingsbury, from the University of Leeds and NIHR Leeds Biomedical Research Centre at Chapel Allerton Hospital, said: “There is some scientific basis as to why hydroxychloroquine could be an effective drug agent. It is known to target inflammation in the joints and is a recognised and licensed treatment for rheumatoid arthritis. There is increasing evidence that inflammation is a factor in osteoarthritis. So doctors have used hydroxychloroquine off-label, in a way that it was not licensed for, to try and control symptoms and pain. But until now, there has not been a large-scale study into whether using hydroxychloroquine works. And our evidence shows that for most patients it is not an effective treatment.”


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