{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:36:26Z","timestamp":1761060986766,"version":"3.37.3"},"reference-count":45,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T00:00:00Z","timestamp":1581984000000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NHMRC Program Grant","award":["1091302"],"award-info":[{"award-number":["1091302"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Hand osteoarthritis (HOA) is a highly prevalent disabling joint disease. The current management regimens are limited. Potentially as a consequence, many people turn to complementary and alternative medicines for symptomatic relief. A combination of two or more supplements is common in clinical practice; however, evidence for the efficacy of this approach is lacking. The aim of this study is to investigate the efficacy of a supplement combination for treating symptomatic HOA in comparison to placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>The RADIANT study is an internet-based, parallel, superiority, double-blind, placebo-controlled, randomised, two-arm clinical trial. A participatory design is used to facilitate the study procedures. One hundred and six participants aged over 40 years with painful HOA and structural change on X-ray (Kellgren and Lawrence grade (KLG) \u22652) will be recruited from the community and randomly allocated to receive either a supplement combination composed of: (1) combined supplement containing<jats:italic>Boswellia serrata<\/jats:italic>extract, pine bark extract and methylsulfonylmethane and (2) curcumin or placebo for 12 weeks. The primary outcome will be 12-week change in hand pain on a visual analogue scale (VAS). Main secondary outcomes include adverse events, change in hand function, patient global assessment of disease activity and quality of life. A range of additional measures will be recorded, and an individual patient placebo response will be performed. The primary analysis will be conducted using an intention-to-treat approach. Adverse events will be monitored weekly throughout the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>This protocol has been approved by the University of Sydney Human Research Ethics Committee (HREC No. 2018\/766). Dissemination will occur through conferences, social media, scientific publications and PhD thesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>Australian New Zealand Clinical Trials Registry (ACTRN12619000835145); Pre-results<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2019-035672","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T09:29:07Z","timestamp":1582104547000},"page":"e035672","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy and safety of a supplement combination for hand osteoarthritis pain: protocol for an internet-based randomised placebo-controlled trial (The RADIANT study)"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6375-1800","authenticated-orcid":false,"given":"Xiaoqian","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Robbins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian","family":"Eyles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatyana","family":"Fedorova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonika","family":"Virk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leticia A","family":"Deveza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"McLachlan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3197-752X","authenticated-orcid":false,"given":"David","family":"Hunter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,18]]},"reference":[{"key":"2020050713302414000_10.2.e035672.1"},{"key":"2020050713302414000_10.2.e035672.2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204763"},{"key":"2020050713302414000_10.2.e035672.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.08.004"},{"key":"2020050713302414000_10.2.e035672.4","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.150078"},{"key":"2020050713302414000_10.2.e035672.5","doi-asserted-by":"crossref","first-page":"767","DOI":"10.3109\/14397595.2015.1130673","article-title":"Prevalence of hand osteoarthritis and its relationship to hand pain and grip strength in Japan: the third survey of the road study","volume":"26","author":"Kodama","year":"2016","journal-title":"Mod Rheumatol"},{"key":"2020050713302414000_10.2.e035672.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.semarthrit.2017.12.003","article-title":"Guidelines for the conduct of pharmacological clinical trials in hand osteoarthritis: consensus of a working group of the European Society on clinical and economic aspects of osteoporosis, osteoarthritis and musculoskeletal diseases (ESCEO)","volume":"48","author":"Reginster","year":"2018","journal-title":"Semin Arthritis Rheum"},{"key":"2020050713302414000_10.2.e035672.7","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2013.214"},{"key":"2020050713302414000_10.2.e035672.8","doi-asserted-by":"publisher","DOI":"10.1111\/jphp.12196"},{"key":"2020050713302414000_10.2.e035672.9","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21596"},{"key":"2020050713302414000_10.2.e035672.10","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213826"},{"key":"2020050713302414000_10.2.e035672.11","first-page":"Je01","article-title":"Use of complementary and alternative medicine among osteoarthritic patients: a review","volume":"10","author":"Khan","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"2020050713302414000_10.2.e035672.12","doi-asserted-by":"crossref","unstructured":"Corp N , Jordan JL , Croft PR . 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