Intra-Articular Corticosteroid Injections have long term pain relief benefit among Osteoarthritis patients, claims study
Researchers have found in a new study that intra-articular steroid injections were associated with a reduced need for opioids, both alone and in combination products among osteoarthritis patients.
This benefit was observed for injections into the hip, shoulder, hand, and knee. British patients who received these injections showed decreased usage of opioid-containing drugs and other painkillers for years afterwards.
A study was done to estimate the effect of intra-articular corticosteroid injection (IACI) for osteoarthritis on longer-term incidence of pain medications.
They conducted a cohort study of patients registered in the UK Clinical Practice Research Datalink (CPRD) GOLD primary care database with an incident diagnosis of knee, hip, hand, or shoulder osteoarthritis between 2005–2019. Exposure of interest was single or repeated use of IACI (analysed separately). Main outcome measures were five-year incidence of uncombined opioids, opioid-nonopioid analgesic combinations, oral corticosteroids, paracetamol, oral Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and topical NSAIDs. Instrumental Variable (IV) analysis was used given this methodology can account for strong and unmeasured confounding. Secondary analyses used propensity-score matching and Cox regression.
Results: Amongst 74 527 knee osteoarthritis patients, IACI use was associated with lower subsequent prescribing of most pain medications studied, including opioid-nonopioid analgesic combinations following single IACI (number needed to treat [NNT]=5 [5–6], p< 0.001) and uncombined opioids following repeat IACI (NNT = 12 [95% CI: 8–546], p= 0.049).
Amongst 15 092 hand osteoarthritis patients, single IACI was associated with reduced use of opioid-nonopioid combinations, paracetamol, and oral NSAIDs. Secondary analyses confirmed lower incidence rates of opioid-nonopioid combinations after single IACI for knee (hazard ratio [HR] =0.88 [0.81–0.96]), hip (HR = 0.76 [0.62–0.92]), hand (HR = 0.77 [0.61–0.98]), or shoulder (HR = 0.72 [0.53–0.99]) osteoarthritis. IACI for knee or hand osteoarthritis showed lower incidence of several pain medications over the longer-term relative to no IACI use. Secondary findings suggest IACI may be effective in reducing longer-term use of opioid-nonopioid analgesic combinations for patients with knee, hip, hand, or shoulder osteoarthritis.
Reference:
Samuel Hawley, Albert Prats-Uribe, Gulraj S Matharu, Antonella Delmestri, Daniel Prieto-Alhambra, Andrew Judge, Michael R Whitehouse, Effect of intra-articular corticosteroid injections for osteoarthritis on the subsequent use of pain medications: a UK CPRD cohort study, Rheumatology, 2025;, keaf126, https://doi.org/10.1093/rheumatology/keaf126
