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Will oestrogen therapy give HOPE to post-menopausal women?

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Researchers at the Nuffield Orthopaedic Centre (NOC) are recruiting post-menopausal women for a pilot study to see whether painful osteoarthritis in joints of their hands can be treated with a therapy containing oestrogen.

The HOPE-e study is looking to recruit up to 90 patients from three sites in the UK. As well as the NOC, the trial is running at Charing Cross Hospital, Imperial College Healthcare in London, and the White Horse Medical Practice in Faringdon, Oxfordshire.

The people taking part in the study will be women aged between 40 and 65 years and between one and 10 years post-menopause. Half of those recruited will receive the therapy and the rest a placebo (inactive tablet).

Hand osteoarthritis (OA) affects more than two million people in the UK, causing pain and functional difficulties for many. It affects eight percent of women and three percent of men over the age of 45. Currently there is no cure.

There are few evidence-based interventions to tackle the condition, other than pain relief and exercise, which are often inadequate.

Around 90 percent of those seeking specialist care for symptomatic hand OA are women. The condition is more common in women, especially around the time of menopause, when levels of the hormone oestrogen fall.

Oestrogen-containing therapy appears to protect from progression of knee and hip OA, but there have so far been no randomised trials testing this type of therapy in individuals with symptomatic OA.

The trial is being led by Professor Fiona Watt, of the University of Oxford's Kennedy Institute of Rheumatology. She said: "We want to see if giving oestrogen-containing therapy to women after the menopause improves hand OA symptoms.

"But first we need to see whether enough women are prepared to take part in this randomised feasibility study. If the HOPE-e study is successful, we will aim to carry out a full-size trial."

HOPE-e stands for Hand Osteoarthritis: investigating Pain Effects in a randomised placebo-controlled feasibility study of oestrogen-containing therapy (HOPE-e).

More information on taking part can be found on the HOPE-e website.