Efficacy and safety of oral low-dose glucocorticoids in patients with estrogen-dependent primary osteoarthritis

Abstract

Estrogen-dependent osteoarthritis (EDPOA) is a disease of perimenopausal-age women. Their manifestations are polyarticular pain with common co-morbidities (carpal tunnel syndrome, insomnia, fatigue, depression, and fibromyalgia). Based on dual role of glucocorticoids, its trophic action on the chondrocyte and its anti-inflammatory effect, we conducted a prospective interventional cohort study where we evaluate the efficacy and safety of oral low-dose GC in one hundred women with EDPOA. The pain intensity, number of tender joints as well as impact in co-morbidities were analyzed. We conclude that the use of low-dose GC in patients with EDPOA can be an effective and a safe therapeutic option.

Antiestrogen agents could be associated with a form of polyarticular osteoarthritis

“…Estrogen-dependent polyarticular OA is a disabling clinical condition present in postmenopausal women in which inflammatory and/ or mechanical arthralgias with polyarticular distribution occur, both in the axial and appendicular skeleton. 6 In our study, 99mTc-PYP SS was performed in most of the patients, and the joints involved were showable by radiotracer uptake; the fusion of CT scan images showed the radiological characteristics of OA. Thus, AEA therapy may be associated with a form of severe OA.…”

“…The development of cartilage-specific estrogen receptor activators may be a future solution for the treatment of this disease. 6 In conclusion, patients with a history of breast cancer and AEA therapy may develop a form of severe polyarticular OA, possibly related to estrogen depletion.…”

“…We believe that AEA therapy-associated arthralgias in some patients may be a form of estrogen-dependent polyarticular osteoarthritis (OA), a similar condition that occurs in postmenopausal patients in a hypoestrogenic state. 6 In the present study, we show a series of patients with symptomatic arthropathy that developed after the start of AEA therapy.Based on clinical and imaging data, an approximation is made to characterize this type of arthropathy.…”

Risk of de novo severe carpal tunnel syndrome after bilateral oophorectomy: a population-based cohort study

“…However, there is only limited evidence supporting this theory 37 . Other explanations include disorders affecting sympathomimetic amines 38 and estrogen deficiency disorders, 39 which may ultimately result in chronic pelvic pain, joint pain, headaches, fibromyalgia, and CTS. Therefore, a woman with a lower threshold to pain may be more likely to report to a care provider for chronic pelvic pain.…”