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

Trial Summary

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.

What data supports the effectiveness of the treatment for basal joint osteoarthritis?

Research shows that both corticosteroids and platelet-rich plasma (PRP) are effective in reducing pain and improving function in conditions like knee osteoarthritis and shoulder periarthritis. PRP may offer better long-term outcomes, while corticosteroids provide quicker short-term relief. ^{1 2 3 4 5}

Is it safe to use PRP and corticosteroid injections in humans?

Both PRP and corticosteroid injections are generally safe for treating various conditions like shoulder pain, knee osteoarthritis, and lumbar spondylosis. Studies have shown no major complications and similar minor complication rates for both treatments. ^{1 2 3 5 6}

How does the treatment of PRP compare to corticosteroids for osteoarthritis?

PRP (Platelet-Rich Plasma) injections may offer longer-lasting relief compared to corticosteroid injections for osteoarthritis, as they are suggested to be more effective over time, although both treatments are effective in reducing pain and improving function in the short term. ^{3 5 6 7 8}

What is the purpose of this trial?

Single blinded PRP vs. Corticosteroid vs. Placebo (normal saline) intra-articular injection for basal joint arthritis.

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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 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]

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 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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Effects of corticosteroids and platelet-rich plasma on synoviocytes in IL-1ß-induced inflammatory condition. [2022]

2. Pakistan pubmed.ncbi.nlm.nih.gov

Clinical efficacy of Platelet-Rich Plasma versus local Methylprednisolone Injection in Lateral Epicondylitis. [2023]

3. United States 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. [2022]

4. United States 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. [2023]

5. United States 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. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Platelet-Rich Plasma Versus Corticosteroid Injection for Lumbar Spondylosis and Sacroiliac Arthropathy: A Systematic Review of Comparative Studies. [2023]

7. England 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. [2021]

8. Switzerland 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. [2023]