Osteoarthritis patients with severe pain 'benefit most from glucocorticoid therapy'

People with knee and hip osteoarthritis who are afflicted by extreme pain are more likely to benefit from treatment with glucocorticoids, according to a new study.

The international research project - which involved scientists from the Arthritis Research UK Centre of Excellence for Sports, Exercise and Osteoarthritis at the University of Oxford, and the Arthritis Research UK Primary Care Centre at Keele University - aimed to assess the benefits of intra-articular glucocorticoids for specific subgroups of patients with knee or hip osteoarthritis.

Glucocorticoids are a type of steroid-based therapy that have been used for the treatment of arthritis since the 1940s. They can be injected directly into the joints to address inflammation and offer pain relief.

For this new study - led by the Erasmus MC Medical University Center in Rotterdam - data from seven published clinical trials was analysed, encompassing information on 620 patients. These studies were published between 1995 and 2012.

According to results published in the medical journal Osteoarthritis and Cartilage, patients with a severe amount of pain at the beginning of the study period had a significantly larger reduction in short-term pain, though this effect did not persist over the medium to long term.

The researchers concluded: "This individual patient data meta-analysis demonstrates that patients with severe knee pain at baseline derive more benefit from intra-articular glucocorticoid injection at short-term follow-up than those with less severe pain at baseline."

Dr Katherine Free, research liaison and communications manager at Arthritis Research UK, said: "Osteoarthritis is a painful and debilitating condition, affecting around eight million people in the UK. There are many different treatments for this condition, including painkillers, injections and exercise programmes; however, the effectiveness of treatments does vary between individuals.

"Identifying which patients are most likely to respond to specific treatments is currently a major area of research. This international research project suggests that glucocorticoid therapy can be most effective in people with severe osteoarthritis, which is encouraging as this form of the condition is often the hardest to treat."

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