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Corticosteroid injections in polymyalgia rheumatica: a double-blind, prospective, randomized, placebo controlled
C Salvarani1, F Cantini, I Olivieri
1Divisione di Reumatologia, Arcispedale S. Maria Nuova, Reggio Emilia, Italy. salvarani.carlo@asmn.re.it
The Journal of Rheumatology
|June 14, 2000
Summary
Shoulder corticosteroid injections effectively treated polymyalgia rheumatica (PMR) symptoms in a study. This safe therapy significantly reduced pain and stiffness compared to placebo, with MRI showing lesion improvement.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Polymyalgia rheumatica (PMR) is an inflammatory condition causing muscle pain and stiffness.
- Shoulder involvement is common in PMR, impacting patient quality of life.
Purpose of the Study:
- To evaluate the efficacy and safety of corticosteroid injections in the shoulder for treating active PMR.
- To assess the impact of these injections on clinical symptoms and inflammatory markers.
Main Methods:
- A randomized, double-blind, placebo-controlled study involving 20 PMR patients.
- Patients received either 40 mg of 6-methylprednisolone acetate or saline placebo in their shoulders.
- Response criteria included a 70% reduction in pain and stiffness; MRI evaluated shoulder lesions.
Main Results:
- All 10 corticosteroid-injected patients showed significant symptom improvement after the first injection.
- Placebo group showed no response; the difference between groups was statistically significant (p=0.03).
- Magnetic resonance imaging (MRI) revealed marked improvement and near-complete resolution of shoulder lesions in responders.
Conclusions:
- Shoulder corticosteroid injections represent a safe and effective treatment for polymyalgia rheumatica.
- This therapeutic approach offers significant symptom relief and objective improvement in inflammatory markers and joint lesions.