Local sacroiliac injections in the treatment of spondyloarthritis. What is the evidence? |
| |
| Institution: | 1. Department of Rheumatology, University Teaching Hospital, CHRU de Besançon, boulevard Fleming, 25030 Besançon, France;2. EA4266, EPILAB, Université Bourgogne Franche-Comté, 25030 Besançon, France;1. Service de rhumatologie, CHU de Strasbourg, Strasbourg, France;2. Centre national de références des maladies systémiques et auto-immunes rares Est Sud-Ouest (RESO), université de Strasbourg, Strasbourg, France;1. University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France;2. Rheumatology, R Salengro Hospital, University of Lille, Lille, France;3. Departement de Rhumatologie, Henri Mondor Hospital, AP–HP, Université Paris Est Créteil, EA 7379 - EpidermE, 94010, Créteil, France;4. Rheumatology, UMR 1027 Inserm, Paul Sabatier University and Purpan Hospital, Toulouse, France. Sorbonne Universités, UPMC Univ, Paris, France;5. Sorbonne Université, inserm, Institut Pierre-Louis d’épidémiologie et de santé Publique, Paris, France;6. Pitié Salpêtrière hospital, AP–HP, Rheumatology department, Paris, France;7. Paris Descartes University, Department of Rheumatology - Hôpital Cochin. Assistance publique–Hôpitaux de Paris. inserm (U1153): Clinical epidemiology and biostatistics, Université de Paris, Paris, France;8. Department of Rheumatology, CHU Montpellier and UMR5535 CNRS, Montpellier, France;9. Department of rheumatology, CHU Rouen, Rouen, France;10. Department of Rheumatology, Gabriel Montpied University Hospital, Clermont-Ferrand, France;11. Department of Rheumatology, CHRU Besançon, and EA 4266, Université de Franche-Comté, Besançon, France;12. Department of Rheumatology - Hôpital Cochin, Assistance Publique–Hôpitaux de Paris, Paris, France;13. AP–HM, Rheumatology Department, Sainte Marguerite Hospital, Marseille, France;14. Rheumatologist, Yvetot, France;1. Service de Rhumatologie, CHU Clermont-Ferrand, Université Clermont Auvergne, France;2. Department of Educational Studies, Macquarie University, Sydney, New South Wales, Australia, and the Department of Health and Medical Sciences, Swinburne University of Technology, Melbourne, Australia;3. Université Angers, UMR_S1085, CHU Angers, Université Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France;4. UVSQ, U1168 (VIMA: Aging and chronic diseases, Epidemiological and public health approaches), UMS 011 (Population-based Epidemiologic Cohorts Unit), Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, Villejuif, France;5. CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Occupational and Preventive Medicine, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France;1. Unité Rhumatologique des Affections de la Main (URAM), department of rheumatology, Viggo-Petersen Center, university hospital Lariboisière-Fernand-Widal, Paris university, 75010, France;2. Department of physical medicine and rehabilitation, university hospital Lariboisière-Fernand-Widal, Paris university, Paris, 75010, France |
| |
| Abstract: | Local sacroiliac injections represent an available treatment option in spondyloarthritis (SpA). There is no synthetic data about efficacy of this procedure in SpA. The aim of this review is to analyze the available data of the literature of local sacroiliac injections in SpA.MethodsA Pubmed search of papers published after 1990 was performed.ResultsPubmed search retained 15 publications in spondyloarthritis, 12 with corticosteroids (total of 468 injections in 268 patients), including 2 small-sized controlled studies, and 3 with TNF blockers (24 patients in open studies). With steroids, the two controlled studies (with a total number of 30 patients only) demonstrated significant results over placebo. In open studies, good response was reported in more than 80% of the cases, with a mean duration of improvement over 8 months. Reduction of sacroiliac inflammation on MRI was also found in several studies after injection. There is no consensus about the technique of injection or the type of steroid injected. No particular safety concern was reported. Many limitations have to be considered in the interpretation of these results.ConclusionThis kind of procedure should be kept in the therapeutic armament in the current setting of costly targeted systemic treatments of spondyloarthritis. However, definition of a clear position in the treatment strategy needs further well-conducted studies. |
| |
| Keywords: | Spondyloarthritis Treatment Sacroiliac joint Intra-articular injection Steroids Anti-TNF agents |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
