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).