Recent studies have revealed how corticosteroid injections may boost disease progression. Such injections are usually used to treat knee osteoarthritis pain. According to SciTechDaily, the findings of such studies were recently relayed during the RSNA (Radiological Society of North America) meeting.
Osteoarthritis
Over 35.2 million adults in the US get affected by osteoarthritis. According to NBC News, the condition is marked by joint cartilage breakdown and degeneration that leads to stiffness and pain.
Knee osteoarthritis, specifically, impacts around 800,000 individuals annually. The condition is progressive and chronic and may lead to pain and movement difficulties. SciTechDaily reports that around 10% of those with this specific condition opt for noninvasive treatments. They also avail of hyaluronic acid or corticosteroid injections to relieve the pain.
Study 1: Corticosteroid Significantly Boosts Osteoarthritis Progression
The research teams across both studies got their cohorts from Osteoarthritis Initiative, a longitudinal, multicenter, and observational research covering almost 5,000 individuals dealing with knee osteoarthritis in the 14th follow-up year.
The scientists covered 210 participants from the said initiative for the first study. Seventy participants got injected intra-articularly, while a control group comprising 140 individuals did not get injected for two years. Among the 70 individuals who got injected, 44 received corticosteroid injections, while 26 got hyaluronic acid jabs. The researchers matched both groups according to sex, age, BMI, condition severity, and physical activity and pain scores.
Each patient underwent MRI upon injection, as well as two years prior and two years after. The scans were evaluated using WORMS (Whole-Organ Magnetic Resonance Imaging Score), a knee osteoarthritis grading system that grants attention to the bone marrow lesions, joint effusion, ligaments, and meniscus. The scientists noted the progression of osteoarthritis by comparing imaging results during the initial scans and the follow-up ones over two years.
Statistical results showed how corticosteroid injections were significantly linked to osteoarthritis' overall growth in the knee, specifically within the medial cartilage, lateral cartilage, and lateral meniscus. On the other hand, hyaluronic acid knee jabs did not show significant associations with disease progression.
Study 2: Corticosteroid Jabs Still Seen to be a Culprit for Disease Progression
For the second study, the scientists performed case-controlled research, wherein they compared how osteoarthritis radiographically progressed among those who received hyaluronic acid and corticosteroid jabs.
The team had a cohort comprising 150 patients with characteristics similar to the baseline from Osteoarthritis Initiative. Their cohort covered 50 individuals who got corticosteroid jabs and 50 who received hyaluronic acid counterparts. The remaining 50 did not get any injections for over 36 months.
The patients underwent knee X-ray imaging between baseline and two years after. The researchers analyzed the X-ray imaging, including bone spur formation and narrowing of joint space.
Compared to the hyaluronic acid and control groups, the patients who received corticosteroid jabs had significantly higher progression of osteoarthritis. This included space narrowing of the medial joint, a marker of the condition.
Such findings suggest that hyaluronic acid jabs should be further looked into when managing knee osteoarthritis and that corticosteroid jabs should be more cautiously employed.
According to News Medical, University of California research fellow Dr. Upasana Upadhyay expresses how knowing the long-term impacts of such jabs may assist osteoarthritis specialists and patients in making better decisions regarding managing the condition and pain.
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