Patterns of intra-articular injection use after initiation of treatment in patients with knee osteoarthritis: data from the osteoarthritis initiative.

Autor: Liu SH; Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA, 01655, USA. Electronic address: ShaoHsien.Liu@umassmed.edu., Dubé CE; Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA. Electronic address: Catherine.Dube@umassmed.edu., Driban JB; Division of Rheumatology, Tufts Medical Center, Boston, MA, 02111, USA. Electronic address: Jeffrey.Driban@tufts.edu., McAlindon TE; Division of Rheumatology, Tufts Medical Center, Boston, MA, 02111, USA. Electronic address: tmcalindon@tuftsmedicalcenter.org., Eaton CB; Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI, 02860, USA; Departments of Family Medicine and Epidemiology, Warren Alpert Medical School, School of Public Health, Brown University, Providence, RI, 02912, USA. Electronic address: Charles_Eaton@mhri.org., Lapane KL; Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA. Electronic address: Kate.Lapane@umassmed.edu.
Jazyk: angličtina
Zdroj: Osteoarthritis and cartilage [Osteoarthritis Cartilage] 2017 Oct; Vol. 25 (10), pp. 1607-1614. Date of Electronic Publication: 2017 Jun 13.
DOI: 10.1016/j.joca.2017.05.023
Abstrakt: Objective: We sought to describe and evaluate longitudinal use of intra-articular injections after treatment initiation among adults with radiographically confirmed knee osteoarthritis (OA).
Method: Using data from the Osteoarthritis Initiative (OAI), we included participants with radiographically confirmed OA (Kellgren-Lawrence grade (K-L) ≥ 2) in ≥1 knee at baseline. With 9 years of data, 412 participants newly initiating hyaluronic acid or corticosteroid injections with their index visit were identified. For each type of injection initiated, socio-demographic and clinical characteristics were described by patterns of treatments (one-time use, switched, or continued injections). Multinomial logistic models estimated the extent to which patient-reported symptoms (post-initial injection and changes over time) were associated with patterns of injection use.
Results: Of those initiating injections, ∼19% switched, ∼21% continued injection type, and ∼60% did not report any additional injections. For participants initiating corticosteroid injections, greater symptoms post-initial injection were associated with lower odds of continued use compared to one-time users (adjusted odds ratio (aOR) for Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain: 0.91; 95%, confidence interval (CI): 0.83 to 0.99; aOR stiffness : 0.77; CI: 0.63 to 0.94; aOR physical function : 0.97; CI: 0.94 to 1.00). Symptom changes over time (e.g., worsened or improved) were not associated with patterns of injections use.
Conclusion: After treatment initiation, the proportion of patients switching injection use and one-time users was substantial. Symptoms post-initial injection appear to be associated with patterns of injection use. The extent to which these patterns are an indication of lack of impact on patient-reported symptoms should be explored.
(Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: