gms | German Medical Science

Introduction: Thermal therapy seems to be an effective therapeutic tool in different rheumatoid conditions affecting the hands [1]. To evaluate the effectiveness of a waterfiltered infrared therapy (wIRA) applied to both hands of patients with osteoarthritis, non-inflammatory arthralgia and recent-onset arthritis in a prospective, open-label, non-randomized setting.

Methods: Adult patients with hand osteoarthritis (OA), non-inflammatory arthralgia with complaints in the hands and recent-onset arthritis receive waterfiltered infrared therapy (wIRA) of both hands 3x30 minutes per week over 4 weeks; at each visit, wIRA is applied 15 minutes each from palmar and dorsal. Exclusion criteria are hand trauma, surgery of hands, current systemic antiinflammatory therapy (e.g. corticosteroids), infectious or other known rheumatic disease. The following parameters will be evaluated: patient’s global, physician’s global, patient’s pain (each VAS 0-100mm), duration of morning stiffness (minutes), tender joints (TJC-28, TJC-68), swollen joints (SJC-28, SJC-68), clinical disease activity index (CDAI), and the self-reported functional score HAQ (= health assessment questionnaire). Furthermore, musculoskeletal ultrasound in greyscale and power Doppler of MCP and PIP joints will be performed.

Results: So far, 17 patients (female 94.1%, mean age (SD) 59.7 (8.3) years) have been included, of which n=16 finished the wIRA study according to the protocol (n=2 with non-inflammatory arthralgia and n=14 with hand OA). From baseline (BL) to week 4, mean (SD) patient’s global was reduced from 51.9mm (24.8) to 35.6mm (26.5; p=0.003), physician’s global from 15.9mm (9.4) to 11.6mm (8.3; p<0.001), and patient’s pain from 46.2mm (26.1) to 32.4mm (24.1; p=0.008). No positive effect on the duration of morning stiffness via wIRA could be detected (mean (SD) 21.8 min. (29.5) at BL, 22.2 min. (31.5) after 4 weeks). The number of tender/swollen joints was only reduced by trend. CDAI was significantly reduced from 13.0 (7.7) at BL to 9.8 (8.0) after 4 weeks (p=0.001). Also, HAQ was significantly reduced (0.7 (0.5) at BL to 0.5 (0.4) at week 4; p<0.001).

Conclusion: According to the preliminary data on patients with hand OA and non-inflammatory arthralgia, wIRA therapy applied on both hands seems to be an effective therapy on pain and on global disease burden, moreover on self-reported functional status. Further inclusion of eligible patients in this analysis is needed, also to compare the effect of wIRA in different rheumatic conditions.

Disclosures: No disclosures