Evaluation of the effectiveness of intra-articular injections of glucocorticoids in knee synovitis in patients with rheumatic diseases in real clinical practice

Abstract

Intra-articular injections of glucocorticoids are widely used in the complex therapy of rheumatic diseases (RD). However, there is insufficient data on their effectiveness and safety in real clinical practice.The aim of the study – to evaluate the effectiveness of intra-articular injections of glucocorticoids in rheumatic diseases in real clinical practice.Material and methods. The study group consisted of 290 patients with RD, mainly osteoarthritis (OA) and rheumatoid arthritis (RA) (69.0% – women; age – 55.6±12.6 years), who underwent intra-articular injections of glucocorticoids in the knee joint. Indications for intra-articular injections of glucocorticoids were determined by the attending physicians. The control group consisted of 112 patients with OA (71.4% – women; age 59.3±14.6 years) who underwent a course of intra-articular injections of hyaluronic acid. The result of treatment was evaluated in 2 weeks, 1 and 3 months according to a telephone survey.Result. After 2 weeks, 1 month and 3 months after the intra-articular injections of glucocorticoids, the severity of pain during movement decreased (numerical rating scale (NRS) 0–10; Me [25%; 75%]) from 6.0 [4.0; 8.0] to 1,0 [0; 2,0], 2,0 [1,0; 4,0] and 2.5 [1.0; 4.0] respectively (p<0.001). After 3 months, the number of patients with no pain or mild pain (<4 NRS) was 63.8%, with complete/almost complete absence of pain (≤1 NRS) – 30.3%. The effect of intraarticular injections of glucocorticoids was higher in RA than in OA: pain dynamics after 3 months –4.0 [–2.0; –6.0] and –2.0 [–1.0; –5.0] respectively (p=0.003). In OA, the effect of intra-articular injections of glucocorticoids and of hyaluronic acid did not differ: the dynamics of pain after 3 months was –2.0 [–1.0; –5.0] and –3.0 [–1.0; –5.0] respectively (p=0.869). No serious adverse reactions were noted at intra-articular injections of glucocorticoids.Conclusions. Intra-articular injections of glucocorticoids are an effective and fairly safe method of short-term treatment of synovitis in rheumatic diseases.