Human studies
PROMs were the most studied outcome measure for symptom-modifying changes in humans, and more than one modality was usually applied (visual acuity scale, WOMAC, PGA, SF-36, SPADI, and others). Functional tests, ROM, joint tenderness or stiffness, and physician global assessment were also assessed in some studies.
TA consistently improved all PROMs in four studies, with only one author reporting no significant changes (Lattermann et al., 2017). Improvement time after TA injection varied from 4–12 weeks (Chao et al., 2010; Yavuz et al., 2012; Gialanella & Bertolinelli, 2013; Shrestha et al., 2018). TA improved active ROM for up to 12 weeks, while no changes were found in passive ROM (Gialanella & Bertolinelli, 2013). Non-steroid use was not affected by TA injection when evaluated by one group (Gialanella & Bertolinelli, 2013).
When TH was assessed, significant improvements in at least one PROM in all five studies investigating this corticosteroid were found, although most reported improvements only up to 12 weeks (Gaffney et al., 1995; Carette et al., 2003; Meenagh et al., 2004; Mendes et al., 2019), with one author observing more extended positive effects (up to 52 weeks) (Nunes-Tamashiro et al., 2022). TH use did not affect functional tests and joint tenderness and stiffness (Mendes et al., 2019; Nunes-Tamashiro et al., 2022), (Meenagh et al., 2004). Effects on ROM were inconsistent; one study found significant improvements up to 24 weeks (Carette et al., 2003), while two others reported no significant changes (Mendes et al., 2019; Nunes-Tamashiro et al., 2022).
MPA was investigated in three studies with human patients, which demonstrated improvements in PROMs in all despite the duration of reported effects varying with one crossover demonstrating improvements up to three weeks only (Jones & Doherty, 1996); others showed improvements for up to 12 weeks (Young et al., 2001; Yavuz et al., 2012). No significant changes were found for functional tests after MPA treatment (Jones & Doherty, 1996; Young et al., 2001).
BTM was investigated in two studies, and again, conflicting results were found with no significant changes in PROMs, function tests, or ROM in 26 weeks reported by Heyworth et al. (2008) and significant improvements for PROMs and functional tests at 12 weeks in Yavuz et al. (2012). Finally, one author did not specify corticosteroid type but found significant improvements after corticosteroid injections in pain perception, functional tests, and analgesic use at 24 weeks (Leung et al., 2011).