Predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections

Background/Aims To investigate the short- and long-term efficacy of intra-articular glucocorticoid injections (IAGI) in patients with rheumatoid arthritis (RA). Methods This was a retrospective study of RA patients who had active arthritis in the hand or wrist joints and who received IAGI (or not) a...

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Autores principales:	Jung Hee Koh, Hanna Lee, Seung-Geun Lee
Formato:	article
Lenguaje:	EN
Publicado:	The Korean Association of Internal Medicine 2021
Materias:	rheumatoid arthritis intra-articular injection glucocorticoids disease progression wrist Medicine R
Acceso en línea:	https://doaj.org/article/d833836f50f74cb78e720273532408a1
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spelling	oai:doaj.org-article:d833836f50f74cb78e720273532408a12021-11-08T00:59:06ZPredictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections1226-33032005-664810.3904/kjim.2020.189https://doaj.org/article/d833836f50f74cb78e720273532408a12021-11-01T00:00:00Zhttp://www.kjim.org/upload/pdf/kjim-2020-189.pdfhttps://doaj.org/toc/1226-3303https://doaj.org/toc/2005-6648Background/Aims To investigate the short- and long-term efficacy of intra-articular glucocorticoid injections (IAGI) in patients with rheumatoid arthritis (RA). Methods This was a retrospective study of RA patients who had active arthritis in the hand or wrist joints and who received IAGI (or not) as an adjunct to disease-modifying antirheumatic drugs (DMARDs). Short-term efficacy was assessed based on changes in the disease activity score in 28 joints (DAS28) after 3 months and long-term efficacy was assessed based on changes in the van der Heijde Sharp score (HSS) of hand radiographs over 2 years. Radiographic progression was defined as ΔHSS/year ≥ 2. Logistic regression analysis identified predictors of early achievement of low disease activity (LDA) and radiographic progression. Results Overall, 126 RA patients received IAGI into the hand or wrist joints and 107 were IAGI-naive. After 3 months, 67% of IAGI-treated patients and 48% of IAGI-naive patients achieved LDA (p = 0.002). Over the next 2 years, 35% of patients treated with IAGI showed radiographic progression compared with 27% of IAGI-naive patients (p = 0.2). IAGI plus biologic DMARDs was associated with achievement of LDA in 3 months. Achieving LDA in 3 months (odds ratio [OR], 0.403; 95% confidence interval [CI], 0.192 to 0.847), wrist arthritis (OR, 2.408; 95% CI, 1.184 to 4.897), and baseline HSS (OR, 1.021; 95% CI, 1.003 to 1.039) were associated with radiographic progression. Conclusions IAGI was associated with early achievement of LDA. LDA was associated with slower radiographic progression. The wrist is more vulnerable to joint damage and requires more aggressive treatment.Jung Hee KohHanna LeeSeung-Geun LeeThe Korean Association of Internal Medicinearticlerheumatoid arthritisintra-articular injectionglucocorticoidsdisease progressionwristMedicineRENThe Korean Journal of Internal Medicine, Vol 36, Iss 6, Pp 1515-1526 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rheumatoid arthritis intra-articular injection glucocorticoids disease progression wrist Medicine R
spellingShingle	rheumatoid arthritis intra-articular injection glucocorticoids disease progression wrist Medicine R Jung Hee Koh Hanna Lee Seung-Geun Lee Predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections
description	Background/Aims To investigate the short- and long-term efficacy of intra-articular glucocorticoid injections (IAGI) in patients with rheumatoid arthritis (RA). Methods This was a retrospective study of RA patients who had active arthritis in the hand or wrist joints and who received IAGI (or not) as an adjunct to disease-modifying antirheumatic drugs (DMARDs). Short-term efficacy was assessed based on changes in the disease activity score in 28 joints (DAS28) after 3 months and long-term efficacy was assessed based on changes in the van der Heijde Sharp score (HSS) of hand radiographs over 2 years. Radiographic progression was defined as ΔHSS/year ≥ 2. Logistic regression analysis identified predictors of early achievement of low disease activity (LDA) and radiographic progression. Results Overall, 126 RA patients received IAGI into the hand or wrist joints and 107 were IAGI-naive. After 3 months, 67% of IAGI-treated patients and 48% of IAGI-naive patients achieved LDA (p = 0.002). Over the next 2 years, 35% of patients treated with IAGI showed radiographic progression compared with 27% of IAGI-naive patients (p = 0.2). IAGI plus biologic DMARDs was associated with achievement of LDA in 3 months. Achieving LDA in 3 months (odds ratio [OR], 0.403; 95% confidence interval [CI], 0.192 to 0.847), wrist arthritis (OR, 2.408; 95% CI, 1.184 to 4.897), and baseline HSS (OR, 1.021; 95% CI, 1.003 to 1.039) were associated with radiographic progression. Conclusions IAGI was associated with early achievement of LDA. LDA was associated with slower radiographic progression. The wrist is more vulnerable to joint damage and requires more aggressive treatment.
format	article
author	Jung Hee Koh Hanna Lee Seung-Geun Lee
author_facet	Jung Hee Koh Hanna Lee Seung-Geun Lee
author_sort	Jung Hee Koh
title	Predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections
title_short	Predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections
title_full	Predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections
title_fullStr	Predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections
title_full_unstemmed	Predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections
title_sort	predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections
publisher	The Korean Association of Internal Medicine
publishDate	2021
url	https://doaj.org/article/d833836f50f74cb78e720273532408a1
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Predictors of joint damage in patients with rheumatoid arthritis: focus on short- and long-term effects of intra-articular glucocorticoid injections

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