Effects of recurrent intra-articular corticosteroid injections for osteoarthritis at 3 months and beyond:a systematic review and meta-analysis in comparison to other injectables
| Autor: | R.L. Donovan, T.A. Edwards, A. Judge, A.W. Blom, S.K. Kunutsor, M.R. Whitehouse |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Platelet-Rich Plasma
Biomedical Engineering Pain Osteoarthritis Knee Injections Intra-Articular meta-analysis osteoarthritis Treatment Outcome injections intra-articular Rheumatology systematic review Adrenal Cortex Hormones patient reported outcome measures Humans Orthopedics and Sports Medicine Hyaluronic Acid steroids |
| Zdroj: | Donovan, R L, Edwards, T, Judge, A, Blom, A W, Kunutsor, S K & Whitehouse, M R 2022, ' Effects of recurrent intra-articular corticosteroid injections for osteoarthritis at 3 months and beyond : a systematic review and meta-analysis in comparison to other injectables ', Osteoarthritis and Cartilage, vol. 30, no. 12, pp. 1658-1669 . https://doi.org/10.1016/j.joca.2022.07.011 |
| DOI: | 10.1016/j.joca.2022.07.011 |
| Popis: | ObjectiveIntra-articular corticosteroid injections (IACIs) provide temporary symptom relief in osteoarthritis (OA). This meta-analysis investigated the effects of recurrent IACIs at three months and beyond.DesignWe searched Medline, Embase and Cochrane from inception to January 2021 for randomised controlled trials (RCTs) of patients with OA who received recurrent IACIs compared with other injectables, placebo or no treatment (primary outcomes: pain, function). Mean differences (MDs) with 95% confidence intervals were reported.ResultsTen RCTs were included (eight knee OA (n=763), two trapeziometacarpal OA (n=121)). Patients received between 2 and 8 injections, varying by trial. Trials compared recurrent IACIs with hyaluronic acid (HA), platelet-rich plasma (PRP), saline or orgotein (follow-up 3-24 months). Greater improvements in pain, function and QoL at 3-24 months were noted for the comparators than with IACIs, with comparators demonstrating an equal or superior effect, or the intervention effect attenuating over follow-up. Recurrent IACIs demonstrated no benefits in pain or function over placebo at 12-24 months. No serious adverse events were recorded. No studies reported on time-to-future interventions, risk of future prosthetic joint infection or other adverse events associated with subsequent joint replacement.ConclusionsRecurrent IACIs often provide inferior (or non-superior) symptom relief compared with other injectables (including placebo). Other injectables (HA, PRP) often yielded greater improvements in pain and function up to 24 months post-injection. Existing RCTs on recurrent IACIs lack sufficient follow-up data to assess disease progression, time-to-future interventions and complications following these. |
| Databáze: | OpenAIRE |
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