{"title":"关节内皮质类固醇：对骨关节炎和关节健康影响的系统综述","authors":"P. K. A. Tokawa, R. Y. A. Baccarin, G. M. Zanotto","doi":"10.1111/eve.14097","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The importance of intra-articular corticosteroid treatment for osteoarthritis, with its possible adverse effects, requires a comprehensive review.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>This review answers the following questions: (1) What evidence is available regarding the symptom-modifying and disease-modifying changes related to a single intra-articular corticosteroid injection for treating osteoarthritis in horses and humans? (2) What evidence suggests corticosteroids are detrimental to equine joint health?</p>\n </section>\n \n <section>\n \n <h3> Study design</h3>\n \n <p>Systematic review.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A systematic search was conducted in June 2022 in PubMed, CAB and the Web of Science. Inclusion criteria were applied to titles and abstracts. For each question, further criteria were applied. The risk of bias was assessed according to the study design.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Searches generated 6417 titles. Twenty-three articles fit all inclusion criteria for single-injection corticosteroid treatments and 21 were included for their relevance to corticosteroid effects on joint health. Single-injection protocols lead to short-term symptom-modifying osteoarthritic changes with conflicting results regarding disease-modifying osteoarthritis effects. Healthy joints demonstrated disturbances in metabolism and tissue changes both in vivo and in vitro after corticosteroid. A dose-dependent effect was found in vitro.</p>\n </section>\n \n <section>\n \n <h3> Main limitations</h3>\n \n <p>There is a lack of studies regarding the questions, primarily for equine species. Furthermore, the majority of studies were rated as ‘unclear risk of bias’.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Symptom-modifying osteoarthritic changes after a single injection are short-term, and a consistent disease-modifying effect on osteoarthritis has yet to be established. Joint health is disturbed by corticosteroids as their effects on normal joints show adverse changes in tissues and metabolism.</p>\n </section>\n </div>","PeriodicalId":11786,"journal":{"name":"Equine Veterinary Education","volume":"37 7","pages":"371-381"},"PeriodicalIF":0.8000,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intra-articular corticosteroids: Systematic review of effects on osteoarthritis and joint health\",\"authors\":\"P. K. A. Tokawa, R. Y. A. Baccarin, G. M. 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Inclusion criteria were applied to titles and abstracts. For each question, further criteria were applied. The risk of bias was assessed according to the study design.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Searches generated 6417 titles. Twenty-three articles fit all inclusion criteria for single-injection corticosteroid treatments and 21 were included for their relevance to corticosteroid effects on joint health. Single-injection protocols lead to short-term symptom-modifying osteoarthritic changes with conflicting results regarding disease-modifying osteoarthritis effects. Healthy joints demonstrated disturbances in metabolism and tissue changes both in vivo and in vitro after corticosteroid. A dose-dependent effect was found in vitro.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Main limitations</h3>\\n \\n <p>There is a lack of studies regarding the questions, primarily for equine species. 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引用次数: 0
摘要
背景关节内皮质类固醇治疗骨关节炎的重要性及其可能的不良反应，需要全面的审查。本综述回答了以下问题：(1)单次关节内皮质类固醇注射治疗马和人骨关节炎相关的症状改善和疾病改善变化有哪些证据？(2)有什么证据表明皮质类固醇对马的关节健康有害？研究设计系统评价。方法于2022年6月在PubMed、CAB和Web of Science中进行系统检索。纳入标准适用于标题和摘要。对于每个问题，应用了进一步的标准。根据研究设计评估偏倚风险。结果搜索产生了6417个标题。23篇文章符合单次注射皮质类固醇治疗的所有纳入标准，21篇文章因其与皮质类固醇对关节健康的影响相关而被纳入。单次注射方案可导致短期症状改善性骨关节炎改变，但关于疾病改善性骨关节炎效果的结果相互矛盾。健康关节在体内和体外均表现出代谢紊乱和组织变化。在体外发现剂量依赖效应。主要限制缺乏关于这些问题的研究，主要是关于马的物种。此外，大多数研究被评为“不明确的偏倚风险”。结论单次注射后骨关节炎的症状改善是短期的，对骨关节炎的一致的疾病改善作用尚未建立。由于皮质类固醇对正常关节的影响显示出组织和代谢的不利变化，因此关节健康受到干扰。
Intra-articular corticosteroids: Systematic review of effects on osteoarthritis and joint health
Background
The importance of intra-articular corticosteroid treatment for osteoarthritis, with its possible adverse effects, requires a comprehensive review.
Objectives
This review answers the following questions: (1) What evidence is available regarding the symptom-modifying and disease-modifying changes related to a single intra-articular corticosteroid injection for treating osteoarthritis in horses and humans? (2) What evidence suggests corticosteroids are detrimental to equine joint health?
Study design
Systematic review.
Methods
A systematic search was conducted in June 2022 in PubMed, CAB and the Web of Science. Inclusion criteria were applied to titles and abstracts. For each question, further criteria were applied. The risk of bias was assessed according to the study design.
Results
Searches generated 6417 titles. Twenty-three articles fit all inclusion criteria for single-injection corticosteroid treatments and 21 were included for their relevance to corticosteroid effects on joint health. Single-injection protocols lead to short-term symptom-modifying osteoarthritic changes with conflicting results regarding disease-modifying osteoarthritis effects. Healthy joints demonstrated disturbances in metabolism and tissue changes both in vivo and in vitro after corticosteroid. A dose-dependent effect was found in vitro.
Main limitations
There is a lack of studies regarding the questions, primarily for equine species. Furthermore, the majority of studies were rated as ‘unclear risk of bias’.
Conclusions
Symptom-modifying osteoarthritic changes after a single injection are short-term, and a consistent disease-modifying effect on osteoarthritis has yet to be established. Joint health is disturbed by corticosteroids as their effects on normal joints show adverse changes in tissues and metabolism.
期刊介绍：
Equine Veterinary Education (EVE) is the official journal of post-graduate education of both the British Equine Veterinary Association (BEVA) and the American Association of Equine Practitioners (AAEP).
Equine Veterinary Education is a monthly, peer-reviewed, subscription-based journal, integrating clinical research papers, review articles and case reports from international sources, covering all aspects of medicine and surgery relating to equids. These papers facilitate the dissemination and implementation of new ideas and techniques relating to clinical veterinary practice, with the ultimate aim of promoting best practice. New developments are placed in perspective, encompassing new concepts and peer commentary. The target audience is veterinarians primarily engaged in the practise of equine medicine and surgery. The educational value of a submitted article is one of the most important criteria that are assessed when deciding whether to accept it for publication. Articles do not necessarily need to contain original or novel information but we welcome submission of this material. The educational value of an article may relate to articles published with it (e.g. a Case Report may not have direct educational value but an associated Clinical Commentary or Review Article published alongside it will enhance the educational value).
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