PRP vs Corticosteroids for Basal Joint Osteoarthritis

Overseen By Naem Mufarreh

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Kettering Health Network

Must not be taking: Corticosteroids

Disqualifiers: Stage 4 arthritis, Fibromyalgia, others

Compensation: Varies

Number of Visits: Unknown

Duration: 6-8 weeks

150 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests different injections to determine which best eases the pain of basal joint osteoarthritis, affecting the thumb's base joint. Researchers compare three treatments: platelet-rich plasma (PRP), corticosteroid injection, and a placebo (a saline solution with no active treatment). This trial suits those with stage 1 to 3 osteoarthritis in their thumb's base joint who have not received a steroid injection there in the past year. Participants will receive one of the three injections to identify which provides the best relief. As an unphased trial, this study offers a unique opportunity to contribute to understanding effective treatments for thumb osteoarthritis.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that platelet-rich plasma (PRP) injections are generally safe for treating conditions like thumb arthritis. Studies have found that PRP can reduce pain and improve hand function without causing major problems.

Corticosteroid injections, also commonly used, provide safe short-term relief. They can quickly ease joint pain, but the relief may not last long. Some studies suggest that PRP might offer better long-term pain relief compared to corticosteroids.

Overall, both treatments are well-tolerated. PRP is promising, especially for those seeking lasting effects without major side effects. Corticosteroids can provide quick relief but may not offer long-term benefits. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Unlike the standard treatments for basal joint osteoarthritis, which often include corticosteroid injections, the investigational treatment using Platelet Rich Plasma (PRP) is unique because it utilizes the patient’s own blood components to promote healing. PRP is thought to enhance tissue repair by delivering a high concentration of growth factors directly to the affected area. Researchers are excited about PRP because it offers a more regenerative approach, potentially reducing inflammation and pain without the side effects commonly associated with steroids. This could lead to longer-lasting relief and improved joint function for patients.

What evidence suggests that this trial's treatments could be effective for basal joint osteoarthritis?

This trial will compare the effectiveness of platelet-rich plasma (PRP) with corticosteroid injections for basal joint osteoarthritis. Studies have shown that PRP can effectively reduce pain and improve movement in people with osteoarthritis, especially when compared to saline or other treatments. Research indicates that PRP provides pain relief and better movement without a higher risk of side effects. In contrast, corticosteroid injections offer short-term pain relief but may not provide long-lasting benefits for pain or movement. Some studies suggest PRP may even surpass corticosteroids in improving pain and patient satisfaction. While both treatments can help manage symptoms, PRP appears more effective for basal joint osteoarthritis. ^{3 5 6 7 8}

Are You a Good Fit for This Trial?

This trial is for people with early to moderate osteoarthritis in the basal joint of the thumb. It's not suitable for those with fibromyalgia, inflammatory diseases, bone tumors, certain wrist conditions like DeQuervain's tenosynovitis recently treated or advanced arthritis as per Eaton stage 4. Pregnant or terminally ill patients and those who've had a corticosteroid injection in the past year at the affected site are also excluded.

Inclusion Criteria

My arthritis in the thumb joint is at an early to moderate stage.

Exclusion Criteria

My thumb joint arthritis is severe (Stage 4).

I have Pressier disease, Kienbock's, or avascular necrosis of the scaphoid.

You are pregnant or have a terminal illness.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive intra-articular injections of either PRP, corticosteroid, or placebo for basal joint arthritis

6-8 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

1 year

What Are the Treatments Tested in This Trial?

Interventions

• Corticosteroid injection
• Normal Saline
• Platelet Concentrate

Trial Overview The study tests three treatments: platelet concentrate (PRP), corticosteroid injections, and placebo (normal saline) injected into the joint. Participants won't know which treatment they're getting but will be randomly assigned to one of these options to compare effectiveness.

How Is the Trial Designed?

Group I: PRP Experimental Treatment 1 Intervention

Intra-articular injection of platelet rich plasma.

Group II: Corticosteroid Active Control 1 Intervention

Intra-articular injection of kenalog.

Group III: Normal Saline Placebo Group 1 Intervention

Intra-articular injection of normal saline

Corticosteroid injection is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Corticosteroids for:

• Allergic reactions
• Asthma
• COPD
• Rheumatoid arthritis
• Osteoarthritis
• Bursitis
• Tendonitis
• Skin conditions
• Eye conditions
• Gastrointestinal disorders

Approved in European Union as Corticosteroids for:

• Allergic reactions
• Asthma
• COPD
• Rheumatoid arthritis
• Osteoarthritis
• Bursitis
• Tendonitis
• Skin conditions
• Eye conditions
• Gastrointestinal disorders

Approved in Canada as Corticosteroids for:

• Allergic reactions
• Asthma
• COPD
• Rheumatoid arthritis
• Osteoarthritis
• Bursitis
• Tendonitis
• Skin conditions
• Eye conditions
• Gastrointestinal disorders

Who Is Running the Clinical Trial?

Kettering Health Network

Lead Sponsor

Trials

20

Recruited

1,700+

Published Research Related to This Trial

Intra-articular platelet-rich plasma (PRP) injections significantly reduce symptoms of knee osteoarthritis (OA) compared to corticosteroid (CS) injections, showing the greatest improvement at 6 and 9 months post-treatment in a review of 8 studies involving 648 patients.

Triple PRP injections, spaced a week apart, are more effective than a single injection, leading to better pain management, reduced stiffness, and improved ability to participate in sports activities over a 12-month follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis. McLarnon, M., Heron, N.[2021]

In a study involving 29 patients with bilateral knee osteoarthritis, both platelet-rich plasma (PRP) and corticosteroid injections were found to effectively improve pain, stiffness, and function over a six-month period.

While PRP showed slightly better results than corticosteroids at the six-month mark, there was no statistically significant difference between the two treatments, indicating that both are viable options for managing knee osteoarthritis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Double-Blind Randomized Controlled Trial Comparing Platelet-Rich Plasma With Intra-Articular Corticosteroid Injections in Patients With Bilateral Knee Osteoarthritis. Pretorius, J., Nemat, N., Alsayed, A., et al.[2022]

In a study of 81 patients with tennis elbow, both platelet-rich plasma (PRP) and methylprednisolone injections resulted in similar reductions in pain and functional disability after 12 months, indicating comparable efficacy.

Patients in both treatment groups reported similar levels of satisfaction with their treatment, suggesting that either PRP or methylprednisolone can be effective options for managing tennis elbow.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical efficacy of Platelet-Rich Plasma versus local Methylprednisolone Injection in Lateral Epicondylitis. Shaikh, SA., Tahir, M., Ahmed, N.[2023]

A systematic review of five studies involving 242 patients found that both platelet-rich plasma (PRP) and corticosteroid injections are safe and effective treatments for lumbar spondylosis and sacroiliac arthropathy, with no major complications reported.

At long-term follow-up (three to six months), PRP injections showed more significant improvements in clinical outcomes compared to corticosteroids, suggesting that PRP may be a more effective option for these conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Platelet-Rich Plasma Versus Corticosteroid Injection for Lumbar Spondylosis and Sacroiliac Arthropathy: A Systematic Review of Comparative Studies. Ling, JF., Wininger, AE., Hirase, T.[2023]

Intra-articular injections of platelet-rich plasma (PRP) resulted in the most significant functional improvement in patients with knee osteoarthritis (KOA) over a 6-month period compared to hyaluronic acid (HA) and glucocorticosteroid (CS) injections, based on the WOMAC score.

While all treatments showed some reduction in pain, the PRP group maintained the best outcomes, particularly in functional improvement, whereas the CS group experienced a rebound in pain levels after 6 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intra-Articular Injection of Platelet-Rich Plasma Is More Effective than Hyaluronic Acid or Steroid Injection in the Treatment of Mild to Moderate Knee Osteoarthritis: A Prospective, Randomized, Triple-Parallel Clinical Trial. Szwedowski, D., Mobasheri, A., Moniuszko, A., et al.[2023]

In a study of 60 patients with de Quervain's tenosynovitis, both platelet-rich plasma (PRP) and corticosteroid injections showed significant improvement in symptoms, but there was no statistical difference in effectiveness between the two treatments.

PRP injections had a lower complication rate compared to corticosteroids, which had a 26.67% complication rate including issues like fat atrophy and increased pain, suggesting PRP may be a safer option despite its higher cost and preparation time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of Clinical and Functional Outcomes after Platelet-Rich Plasma Injection and Corticosteroid Injection for the Treatment of de Quervain's Tenosynovitis. Kumar, V., Talwar, J., Rustagi, A., et al.[2023]

In a study of 60 patients with frozen shoulder, platelet-rich plasma (PRP) injections significantly reduced pain and disability over the long term compared to triamcinolone, with VAS scores of 14.33 for PRP versus 31.63 for triamcinolone after 24 weeks.

While triamcinolone provided better short-term relief, PRP demonstrated superior long-term efficacy in improving shoulder function, as indicated by DASH scores of 18.08 for PRP compared to 31.76 for triamcinolone after the same period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of the Efficacy of Platelet-Rich Plasma (PRP) and Local Corticosteroid Injection in Periarthritis Shoulder: A Prospective, Randomized, Open, Blinded End-Point (PROBE) Study. Gupta, GK., Shekhar, S., Haque, ZU., et al.[2022]

Corticosteroid injections effectively modulate inflammation and maintain synovial homeostasis in shoulder pain, as shown by their regulation of pro-inflammatory and anti-inflammatory cytokines.

When combined with platelet-rich plasma (PRP), corticosteroids enhance the regulation of certain inflammatory markers without interfering with the corticosteroid's effects, suggesting a synergistic benefit in treating inflammation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of corticosteroids and platelet-rich plasma on synoviocytes in IL-1ß-induced inflammatory condition. Yea, JH., Shin, S., Yoon, KS., et al.[2022]

Citations

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The Efficacy of Intra-Articular Versus Extra ... Our data stand in support of that theory, demonstrating that accurate injection of the CMC joint resulted in better outcomes at 3 months. For ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9277790/

Efficacy of corticosteroids for hand osteoarthritis - a systematic ... A previous meta-analysis showed that intra-articular corticosteroid injections were no more effective than placebo in improving pain in ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S2589514124002524

Comparison of Surgical Techniques and Joint Injections for ... Platelet-rich plasma injections had improved pain, function, and patient satisfaction outcomes compared with corticosteroid injections. Conclusions. No surgical ...

4. frontiersin.org frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.637904/full

New Trends in Injection-Based Therapy for Thumb ... The Authors found both IA therapies effective in controlling pain (by VAS) and improving joint functionality (by FIHOA), but the benefits ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0363502324000558

Efficacy of Intra-Articular Corticosteroid Injection for ... Despite short-term improvement with intra-articular corticosteroid injections, there was no significant difference in pain and functional outcomes following ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4641109/

Intra-articular corticosteroid injections to manage ... This study demonstrates that there are potentially significant although short-term benefits to be gained from steroid injections into the TMJ.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT04177433

The Use of Intra-articular Corticosteroid Injection to Treat ... This randomized clinical trial (RCT) will evaluate 6-month outcomes following intra-articular injections for arthritis of the thumb carpometacarpal (CMC) joint ...

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Efficacy of corticosteroids for hand osteoarthritis - a systematic ... Intra-articular corticosteroids showed no significant effect on any clinical outcomes over short (4-6 weeks) or longer term (3-12 months) in ...