Safety of intra-articular glucocorticoid injections - state of the art.

IF 1.4 4区 医学 Q3 RHEUMATOLOGY
ARP Rheumatology Pub Date : 2023-01-01
Ana Margarida Duarte-Monteiro, Eduardo Dourado, João E Fonseca, Fernando Saraiva
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Abstract

Intra-articular glucocorticoid injection (IAGCI) is frequently used to treat joint pain and inflammation. While its efficacy has been extensively studied, there are not as many detailed descriptions regarding safety. This review aimed to describe the immediate-, short- and long-term complications of IAGCI and their predictors. Most studies mainly report mild and self-limited adverse events with an incidence similar to placebo. However, the reported incidences vary significantly and are mostly inferred from retrospective data. Septic arthritis is the most feared adverse event due to its association with high mortality. Other short-term local complications include injection site pain, post-injection flare, skin hypopigmentation and atrophy, and tendon rupture. Systemic side effects are common, including vasovagal reactions, flushing, increased appetite and mood changes, hyperglycemia in diabetic patients, and bleeding in high-risk patients. Few predictors of complications have been systematically evaluated. However, male gender, advanced age, and pre-existing joint disease have been suggested in retrospective studies to correlate with infection risk. Overall, in most studies, only severe adverse event rates are reported, with no systematic prospective evaluations of safety and no report of predictors of complications. Therefore, since IAGCI is a routinely used treatment, more detailed knowledge of adverse events and complications is warranted.

关节内糖皮质激素注射的安全性——最新进展。
关节内糖皮质激素注射(IAGCI)常用于治疗关节疼痛和炎症。虽然对其功效进行了广泛的研究,但对其安全性的详细描述并不多。本综述旨在描述IAGCI的即时、短期和长期并发症及其预测因素。大多数研究主要报告轻度和自限性不良事件,发生率与安慰剂相似。然而,报告的发病率差异很大,而且大多是从回顾性数据推断出来的。脓毒性关节炎是最可怕的不良事件,因为它与高死亡率有关。其他短期局部并发症包括注射部位疼痛、注射后耀斑、皮肤色素减退和萎缩以及肌腱断裂。全身副作用是常见的,包括血管迷走神经反应、潮红、食欲增加和情绪变化、糖尿病患者高血糖和高危患者出血。很少有并发症的预测因素被系统地评估过。然而,回顾性研究表明,男性、高龄和先前存在的关节疾病与感染风险相关。总的来说,在大多数研究中,只报告了严重的不良事件发生率,没有系统的安全性前瞻性评估,也没有并发症预测因素的报告。因此,由于IAGCI是常规使用的治疗方法,因此有必要更详细地了解不良事件和并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
1.20
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0.00%
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