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- Title
Do Glucocorticoid Injections Increase the Risk of Knee Osteoarthritis Progression Over 5 Years?
- Authors
Latourte, Augustin; Rat, Anne‐Christine; Omorou, Abdou; Ngueyon‐Sime, Willy; Eymard, Florent; Sellam, Jérémie; Roux, Christian; Ea, Hang‐Korng; Cohen‐Solal, Martine; Bardin, Thomas; Beaudreuil, Johann; Guillemin, Francis; Richette, Pascal
- Abstract
Objective: Recent findings have demonstrated that intraarticular (IA) glucocorticoid injections can be deleterious for knees with osteoarthritis (OA). This study was undertaken to assess, in a real‐life setting, the risk of knee OA progression in patients who received IA glucocorticoid injections over a 5‐year follow‐up period. Methods: We used marginal structural modeling with inverse probability of treatment weighting to determine the causal association between IA glucocorticoid injections and the 5‐year risk of disease progression in patients with symptomatic knee OA from the Knee and Hip Osteoarthritis Long‐term Assessment cohort. OA progression was defined as an incident total knee replacement (TKR) and/or radiographic worsening (Kellgren/Lawrence [K/L] grade or joint space narrowing [JSN]). We also examined these outcomes in knees that received IA hyaluronan (IAHA) injections. Results: Among the 564 patients with knee OA included in the study sample, 51 (9.0%) and 99 (17.5%) received IA glucocorticoid or IAHA injections, respectively, and 414 (63.1%) did not receive any injection during follow‐up. Compared to untreated knees, those treated with IA glucocorticoid injections had a similar risk of incident TKR (hazard ratio [HR] 0.92 [95% confidence interval (95% CI) 0.20, 4.14]; P = 0.91) or K/L grade worsening (HR 1.33 [95% CI 0.64, 2.79]; P = 0.44). IAHA injections had no effect on the risk of TKR (HR 0.81 [95% CI 0.14, 4.63]; P = 0.81) or K/L grade worsening (HR 1.36 [95% CI 0.85, 2.17]; P = 0.20). Similar results were obtained for JSN, and when TKR and radiographic outcomes were combined. Conclusion: In this study, IA glucocorticoid injections for symptomatic knee OA did not significantly increase the 5‐year risk of incident TKR or radiographic worsening. These findings should be interpreted cautiously and replicated in other cohorts.
- Subjects
GLUCOCORTICOIDS; KNEE osteoarthritis; DISEASE progression; INJECTIONS; HIP osteoarthritis; CONFIDENCE intervals; STRUCTURAL models; RADIOGRAPHY; TREATMENT effectiveness; RISK assessment; DESCRIPTIVE statistics; PROBABILITY theory; DISEASE risk factors
- Publication
Arthritis & Rheumatology, 2022, Vol 74, Issue 8, p1343
- ISSN
2326-5191
- Publication type
Article
- DOI
10.1002/art.42118