In this overview of four randomized controlled trials with parallel group and cross-over design, a total of 276 patients with hand osteoarthritis (OA) were randomized to receive tumor necrosis factor inhibitors (TNF inhibitors), such as adalimumab or etanercept, versus a placebo treatment. The primary outcome of interest was pain reduction measured by visual analog scale (VAS) and the Australian/Canadian Osteoarthritis Hand Index (AUSCAN). Secondary outcomes included improvement in function measured by AUSCAN or Functional Index of Hand Osteoarthritis (FIOHA), grip strength assessed using a dynamometer, stiffness measured by AUSCAN, the count of tender and swollen joints, and structural outcomes, which were evaluated with the use of X-ray, ultrasonography, or MRI. Outcomes were assessed up to 12 months. The study results revealed that TNF inhibitors did not significantly improve pain, function, or grip strength compared to placebo within the one-year period. However, there were some findings related to structural outcomes that suggest a potential effect of TNF inhibitors on slowing disease progression in hand OA patients who exhibit signs of inflammation.