Summary: The presented European League Against Rheumatism (EULAR) recommendations provide up-to-date guidance on the management of hand osteoarthritis (OA), based on expert opinion and research evidence. Symptomatic slow acting drugs for osteoarthritis (SYSADOA) may be used in OA patients for pain relief and improvement in function. Piascledine demonstrated efficacy on OA symptoms in some trials, including hand OA.