March 24, 2015

Ketorolac Injections as Effective as Corticosteroids for Knee Osteoarthritis Pain

By Frances Morin

NATIONAL HARBOR, Md -- March 24, 2015 -- Ketorolac intra-articular knee injections provide pain relief from knee osteoarthritis that is equivalent to improvement with corticosteroids, researchers said here on March 20 at the 31st Annual Meeting of the American Academy of Pain Medicine (AAPM).

While corticosteroid inter-articular knee injection has been considered the gold standard in treatment of knee osteoarthritis, the level and duration of pain relief can be inconsistent.

In order to evaluate the potential role of the non-steroidal anti-inflammatory (NSAID) drug ketorolac for management of the condition, Brandon Goff, Brooke Army Medical Center, Fort Sam Houston, Texas, and colleagues randomised 35 patients in the double-blind study to receive either a ketorolac or corticosteroid inter-articular knee injection.

The injections were all made under ultrasound guidance and follow-up assessments were made at 24 weeks post-injection using a variety of outcome measures.

The results showed significant decreases in the mean visual analogue scale scores (VAS) from baseline at 2 weeks that was similar in both the corticosteroid group (5.2-3.6) and the ketorolac group (6.3-4.6; P < .03). The reported decreases were sustained through 24 weeks.

Patients’ mean increases in scores on the Western Ontario and McMaster Universities Arthritis Index (WOMAC) from baseline to 2 weeks were also similar for the corticosteroid (53-68) and ketorolac groups (49-53; P = .003 for both).

At 24 weeks, there were no significant differences in measures of Knee Society (KS) pain and function and other pain measures through 24 weeks, and there was no correlation between VAS and age, gender or body mass index.

“Pain relief was similar between ketorolac and corticosteroid with no differences in outcome measures,” the authors wrote in their presentation. “Ketorolac is a safe option for knee intra-articular injection that gives similar pain relief to corticosteroid.”

[Presentation title: Is Ketorolac the Next Intra-Articular Knee Injection for Osteoarthritis? A Randomized, Double-Blind Study. Abstract 113]
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