A commentary discusses limitations of the study. Due to difficulties with recruitment, the protocol was modified to also include those with pain that did not flare up in response to withdrawal of NSAIDs, but there were not enough participants to determine whether prednisolone also worked in this subgroup: excluding these participants resulted in a small increase in effect size, suggesting the approach might not be as effective in patients with constant, high levels of pain. Data on the use of repeated courses of prednisolone were not reported and there was no clear message on how long to treat to provide optimal pain relief.
However it concludes overall that these findings provide a clear and effective short-term option for those with hand osteoarthritis pain that flares up in response to withdrawal of NSAIDs, especially if they have symptoms and signs of inflammation, such as night pain, morning stiffness, and soft tissue swelling.