Objectives Intramuscular (i.m.) glucocorticoids (GCs) are commonly prescribed in inflammatory arthritis (IA) and osteoarthritis (OA), yet prospective evidence on factors associated with treatment response remains limited. This study examined the association between baseline clinical characteristics and short-term (2 weeks) pain change following i.m. GC injections in IA and OA patients. Method Our prospective cohort study (Sint Maartenskliniek, Nijmegen) included IA and OA patients receiving an i.m. GC injection between March and June 2024. Numeric Rating Scale (NRS) pain scores were assessed at baseline and at 2, 4, 6, and 12 weeks post-injection. The primary outcome was change in NRS pain at 2 weeks. Associations between baseline characteristics and treatment response measured by NRS pain change were analyzed using univariable and multivariable linear regression. Results Of 299 patients, 240 had available 2-week follow-up data. The median baseline NRS pain was 7 (95% CI, 6.7–7.3), decreasing to 4 (95% CI, 3.7–4.3) at 2 weeks (mean change, − 2.1; 95% CI, − 2.5 to − 1.7). Baseline NRS pain was the only significant predictor of response (β = − 0.516, p < 0.001). Conclusion i.m. GCs administration was followed by a clinically relevant pain reduction in patients with IA and OA. Higher baseline NRS pain is the only factor associated with short-term pain change, whereas other baseline characteristics show no association. These findings suggest that commonly available clinical variables have limited value in explaining variation in short-term treatment response after i.m. GC injections.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> <Emphasis Type="BoldItalic">Key Points</Emphasis> • Baseline NRS pain is the only factor associated with two-week pain improvement after intramuscular glucocorticoids • Other routinely collected clinical characteristics are not significantly associated with treatment response </entry> </row> </tbody> </tgroup> </Table>

Baseline pain severity is associated with short-term pain reduction after intramuscular glucocorticoids; other clinical characteristics are not associated: a prospective cohort study

期刊论文
发表日期：

2026年7月17日

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Sophie M. Gerritsen,
Maike H. M. Wientjes,
Calin D. Popa,
Noortje van Herwaarden,
David F. Ten Cate

摘要

Objectives

Intramuscular (i.m.) glucocorticoids (GCs) are commonly prescribed in inflammatory arthritis (IA) and osteoarthritis (OA), yet prospective evidence on factors associated with treatment response remains limited. This study examined the association between baseline clinical characteristics and short-term (2 weeks) pain change following i.m. GC injections in IA and OA patients.

Method

Our prospective cohort study (Sint Maartenskliniek, Nijmegen) included IA and OA patients receiving an i.m. GC injection between March and June 2024. Numeric Rating Scale (NRS) pain scores were assessed at baseline and at 2, 4, 6, and 12 weeks post-injection. The primary outcome was change in NRS pain at 2 weeks. Associations between baseline characteristics and treatment response measured by NRS pain change were analyzed using univariable and multivariable linear regression.

Results

Of 299 patients, 240 had available 2-week follow-up data. The median baseline NRS pain was 7 (95% CI, 6.7–7.3), decreasing to 4 (95% CI, 3.7–4.3) at 2 weeks (mean change, − 2.1; 95% CI, − 2.5 to − 1.7). Baseline NRS pain was the only significant predictor of response (β = − 0.516, p < 0.001).

Conclusion

i.m. GCs administration was followed by a clinically relevant pain reduction in patients with IA and OA. Higher baseline NRS pain is the only factor associated with short-term pain change, whereas other baseline characteristics show no association. These findings suggest that commonly available clinical variables have limited value in explaining variation in short-term treatment response after i.m. GC injections.

Key Points

• Baseline NRS pain is the only factor associated with two-week pain improvement after intramuscular glucocorticoids

• Other routinely collected clinical characteristics are not significantly associated with treatment response