Common treatment for joint pain may be linked to faster arthritis progression, research suggests - NBC News

One of the astir communal symptom alleviation treatments for arthritis, corticosteroid injections, whitethorn really beryllium associated with faster progression of the disease, according to caller research.

Osteoarthritis, the astir prevalent benignant of arthritis, occurs erstwhile the cartilage that cushions a associated breaks down implicit time, causing symptom and stiffness. More than 32 cardinal U.S. adults endure from the condition, which astir often affects the hands, the hips and the knees. There is nary cure, but the discomfort is sometimes treated with corticosteroid shots. Hyaluronic acerb injections are besides used, though they’re little apt to beryllium covered by insurance.

Two tiny unpublished studies, to beryllium presented Tuesday astatine the Radiological Society of North America’s yearly meeting, recovered that connected average, genu arthritis precocious much rapidly among patients who got corticosteroid injections than those who didn’t. By contrast, hyaluronic acerb injections were associated with slower progression of the illness comparative to a power group.

“Our papers amusement that determination should beryllium overmuch much consciousness that corticosteroids could person imaginable progression of OA,” oregon osteoarthritis, said Azad Darbandi, a aesculapian pupil astatine the Chicago Medical School who co-authored 1 of the studies.

Both studies assessed patients from the Osteoarthritis Initiative, a yearslong observational probe task involving astir 5,000 radical with genu osteoarthritis. Darbandi’s probe analyzed X-rays from 50 patients who got corticosteroid shots, 50 who got hyaluronic acerb and different 50 successful a power group. The scans, collected annually for 4 years, revealed worse arthritis progression among participants injected with corticosteroids compared to the different 2 groups.

The 2nd study, from the University of California, San Francisco, examined MRI scans from 210 participants, 44 of whom received corticosteroid shots and 26 of whom got hyaluronic acid.

The researchers looked astatine scans that were taken astatine the clip of the injections, arsenic good arsenic 2 years earlier and after, and recovered much terrible cartilage deterioration by the two-year follow-up people among the steroid-taking group.

“Knowing that helps patients marque a much informed prime astir if they privation an injection and, if they do, which injection they mightiness prefer,” said Dr. Upasana Bharadwaj, a postdoctoral researcher successful UCSF’s radiology and biomedical imaging section who co-authored the study.

But anterior probe connected this taxable is mixed. A 2019 study suggested that corticosteroid shots successful the hips and the knees could accelerate the information and adjacent hasten the request for associated replacement operations. But an analysis past year recovered a akin progression of arthritis among those who got steroids and those who got hyaluronic acid.

Dr. Jonathan Samuels, a rheumatologist astatine NYU Langone Health, said it’s pugnacious to find causation successful studies similar the 2 caller ones, due to the fact that galore factors tin power the progression of arthritis and nary 2 patients are the same.

“We don’t person the biology to beryllium that the injection itself is causing accelerated damage. It’s hard to link the dots from injection to harm from this preliminary data,” helium said. “But it’s an important question, due to the fact that it’s specified a communal signifier to beryllium injected with steroids.”

Dr. Jason Kim, vice president of osteoarthritis probe programs astatine the Arthritis Foundation, said he’d privation to spot studies with a “much higher illustration size implicit a longer play of time” earlier considering imaginable causal links.

Bharadwaj and Darbandi agreed that much probe is needed, arsenic are adjacent reviews for their studies. 

Bharadwaj noted that her squad did effort to power for the anticipation that radical who got steroid shots were simply much apt to prosecute successful activities that furthered the progression of their arthritis afterward. To bash so, they selected participants who had maintained akin enactment levels passim the survey period.

Darbandi offered a fewer caveats to support successful caput alongside the findings. One, helium said, is that the results don’t needfully bespeak the severity of symptoms patients experienced. Just due to the fact that imaging shows much arthritis progression doesn’t mean a diligent feels much pain. 

And second, helium said, the results shouldn’t pb radical to debar corticosteroid shots successful each situations.

“Even though they mightiness advancement osteoarthritis, it doesn’t mean that there’s nary beneficial facet of it oregon that they should not beryllium used,” Darbandi said, “because they are effectual short-term for putting a Band-Aid connected the pain.”

Kim said his instauration does not urge corticosteroids oregon hyaluronic acerb injections for radical with arthritis. Overall, helium said, amended attraction options are needed truthful that researchers don’t person to “compare 1 imperfect cause to another.”