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07-11-2017 | Rheumatology | News | Article

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Higher risk for knee OA progression with corticosteroid injections

medwireNews: Results of an observational study suggest that intra-articular corticosteroid injections are associated with an increased risk for progression of knee osteoarthritis (OA).

Jie Wei and colleagues, from Central South University in Changsha, China, used the Osteoarthritis Initiative to analyze data from 4796 patients who either had knee OA or were at high risk for developing the condition.

In a propensity score-matched analysis, they found that patients who had received corticosteroid injections had a significant 2.7-fold increased risk for OA worsening or knee replacement compared with those who did not receive such treatment, with incidence rates of 90.0 versus 34.9 per 1000 person–years.

And when a marginal structural model was used to account for time-varying confounders, patients receiving corticosteroid injections had an even greater 5.7-fold increased risk for progression or knee replacement.

Presenting the findings at the 2017 ACR/ARHP Annual Meeting in San Diego, California, USA, Wei speculated that the increased risk for OA progression “may be attributable to an increased [or] excessive physical activity level after pain relief,” or that “corticosteroids may have a detrimental effect on chondrocytes.”

These real-world results support recent randomized trial findings, and indicate that “intra-articular injection of corticosteroids [does] not have a beneficial effect on knee OA progression,” she concluded.

By Claire BarnardClaire Barnard

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