RANKL blockade for erosive hand osteoarthritis: a randomized placebo-controlled phase 2a trial

This study investigated the effects of denosumab, a RANKL inhibitor, on erosive hand osteoarthritis (OA). A randomized, placebo-controlled, double-blind trial (n=100) was conducted over 48 weeks, with an open-label extension to 96 weeks. The primary endpoint was change in the Ghent University Scoring System (GUSS) at week 24. Denosumab significantly reduced radiographic erosive progression compared to placebo at both week 24 and week 48. Fewer new erosive joints developed in the denosumab group. While initial clinical benefits (pain and function) weren't significant at 48 weeks, long-term treatment (96 weeks) showed improvement. The safety profile was comparable to previous studies, with a higher incidence of adverse events in the placebo group.

Ruth Wittoek, Gust Verbruggen, Tine Vanhaverbeke, Roos Colman, Dirk Elewaut