Intramuscular glucocorticoid injection shows pain benefits in hip OA
medwireNews: Intramuscular glucocorticoid injections may offer patients with hip osteoarthritis (OA) some pain relief, randomized controlled trial findings show.
Two weeks after receiving a single injection of triamcinolone acetate 40 mg into the gluteus, 52 patients had a significant 1.3 point greater reduction in pain severity during rest than 54 patients injected intramuscularly with placebo. The researchers say that this difference is “probably clinically relevant.”
Specifically, pain scores measured on an 11-point numerical scale fell from 4.3 points before glucocorticoid injection to 2.6 points after 2 weeks, while they fell from 4.3 to 2.6 points following placebo.
Desirée Dorleijn (Erasmus MC University Medical Center Rotterdam, the Netherlands) and colleagues add that this effect persisted for the entire 12 weeks of follow-up.
For the other two primary endpoints – pain severity during walking and Western Ontario and McMaster University OA Index (WOMAC) pain subscale score – significant differences favoring glucocorticoid injection were not evident until 4 to 6 weeks.
The reduction in pain severity during walking was 1.1, 1.4, and 1.3 points greater with glucocorticoid than placebo injection at the 4-, 6-, and 12-week measurements, respectively, while the difference in WOMAC pain subscale score was 9.9 and 9.6 points at 6 and 12 weeks, respectively.
Also, at almost all follow-up measurements, glucocorticoid injections were associated with significant reductions in WOMAC total score and function and stiffness subscale scores, as well as Hip Disability and OA Outcome Scores for pain.
“The present study shows that systemic treatment with an [intramuscular] glucocorticoid injection is effective compared with placebo on pain reduction in patients with hip OA,” the researchers write in the Annals of the Rheumatic Diseases.
They acknowledge the potential benefits of this as a treatment option given that guideline-recommended intra-articular glucocorticoid injection is an invasive procedure.
“The administration of an [intramuscular] injection is much easier than an [intra-articular] hip joint injection without the need for ultrasound/radiologic guidance and can, therefore, be performed in both secondary and primary care,” they explain.
But the researchers concede that more research is needed to determine the comparative effectiveness of an intramuscular versus an intra-articular glucocorticoid injection.
By Lucy Piper
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