Elsevier

The Lancet

Volume 272, Issue 7048, 27 September 1958, Pages 661-663
The Lancet

ORIGINAL ARTICLES
DELETERIOUS EFFECT OF INTRA-ARTICULAR HYDROCORTISONE

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References (5)

  • G.N. Chandler et al.

    Lancet

    (1958)
  • G.N. Chandler et al.

    Brit. med. J.

    (1958)
There are more references available in the full text version of this article.

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    Subgroup analyses on age and gender included in our NMA indicated that female and elderly patients respond poorly to CCS intra-articular injection treatment. Injectables particularly CCS, which is often debated in literature,69 should be given with caution in the clinics. The proposed mechanism explaining the different effects of CCS — not only injections targeting muscle and joint, but also oral, inhaled, topical use targeting other diseases – on subgroups of patients is absent in current literature, which predicted future trends to encourage more clinical trials with large sample size to substantiate the effect of CCS on different age groups, and gender difference.

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    It is also tempting to speculate that OA patients with high concentrations of autoantibodies might benefit from a local or systemic immune suppressive or immune modulatory therapy targeting B cells. In this context it is interesting that intraarticular cortisone therapy has been reported to exacerbate disease progression in some cases of OA [26], even though it is regarded as safe [27]. Cortisone has been shown to drive immunoglobulin synthesis in plasma cells under pro-inflammatory co-stimulation [28].

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    These adverse effects include atrophy of the adjacent skin, destruction of the cartilage, and condylar resorption. Most studies report arthropathy and condylar degeneration after multiple corticosteroid injections, but there are also a few studies in humans that show resorption after a single injection.29–33 The factors that are involved in condylar resorption after a single use are unclear.

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