Adrenal Suppression
Conditions
Brief summary
To evaluate the effect of intra-articular corticosteroid injection (IACI) of depot preparation of betamethasone on the hypothalamic-pituitary-adrenal (HPA) axis, in patients with osteoarthritis of the knee
Detailed description
Consecutive patients attending the rheumatology or orthopedic clinic with osteoarthritic knee pain, not responding satisfactorily to medical or physical therapy were allocated to group-1 after consent and given IACI of 6 mg of betamethasone acetate/betamethasone sodium phosphate. Following completion of this part, consecutive age- and sex-matched patients were allocated to group-2 and given intra-articular injection of 60 mg of sodium hyaluronate. Just prior to the knee injection and 1, 2, 3, 4 and 8 weeks later, patients had 1 µg adrenocorticotropin hormone (ACTH) stimulation test. Secondary adrenal insufficiency (SAI) was defined as levels of less than 18 ng/ml or a rise of \< than 7 ng/ml of serum cortisol, 30 minutes following the ACTH stimulation test.
Interventions
None listed
Sponsors
The Nazareth Hospital, Israel
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Osteoarthritis of the knee
Exclusion criteria
* Had steroids in the last 3 months. Allergic to steroids
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adrenal Suppression | 2 months | Adrenal gland suupresion and inability to adequately secrete cortisol in response to stress |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| favorable clinical response | 2 months | — |
| Favorable clinical response | 2 months following the steroid injection | Improvement of knee pain by more than 30 points according to visual analogue scale |
Other
| Measure | Time frame |
|---|---|
| Nadir serum cortisol level | 2 months |
Outcome results
None listed