Intra‐articular and soft‐tissue corticosteroid injections and risk of infections: Population‐based self‐controlled‐risk‐interval design

Abstract

Purpose Chronic and short‐term treatment with oral corticosteroids is associated with an increased risk of infection. However, the potential risk of infection that may be associated with intra‐articular and soft‐tissue injections of corticosteroids has not been reported. The aim of this study was to assess the risk for infection following intra‐articular or soft‐tissue corticosteroid injections. Methods Self‐controlled‐risk‐interval study with 15 732 adults who were treated with intra‐articular or soft‐tissue corticosteroid injections during 2015–2018. The study was conducted in a large Israeli Health Maintenance Organization. We self‐matched the participants and analyzed the incidence of infection over three periods: an exposure‐period of 90 days following the injection, and two 90‐day control periods. We identified the occurrence of several common infections in the patient's electronic medical record and analyzed the incidence rates of all infections (composite end‐point) as well as each infection separately. Results The incidence of any infection was higher during postexposure period compared with the control periods (46.5 vs. 42.1 events per 1000 persons), number needed to harm was 227 persons. Self‐matching analysis showed increased incidence‐rate‐ratio (IRR) for the combined incidence of infections in the post‐exposure period compared with the control periods (IRR = 1.10, 95% confidence interval [CI] 1.01–1.21). A sensitivity analysis showed that the highest IRR was during the first 30 days (IRR = 1.19, 95% CI 1.03–1.38), with higher IRR for patients aged 65 years and older (IRR = 1.37, 95% CI 1.08–1.73). Conclusions Intra‐articular and soft‐tissue corticosteroids injections may be associated with an increased risk of infections; however, the absolute risk increase is low.

A Retrospective Analysis of Incidence and Risk Factors for the Development of Secondary Infections Following COVID-19

“…The presence of comorbid conditions of CKD, the need for ICU admission, and the use of steroids were identified as risk factors for UTI. The presence of risk factors such as CKD, 23 administration of steroids such as methylprednisolone, 24 and ICU stay 25 were more prone to develop UTIs. Hence, it is evident that the risk factors for the development of UTI are comorbidity of CKD, steroid administration, and ICU stay.…”

Unraveling the connection: Uveitis prevalence and risk factors in psoriasis patients — a population‐based study

“…This information encompasses diagnostic visits, pharmacological interventions, in‐office procedures, laboratory test results, imaging studies, and summaries of hospital encounters such as outpatient clinic visits, emergency department visits, and in‐patient discharge records. Databases from Israeli HMOs, including Meuhedet, have been established as a credible source for research purposes with data from this source used in numerous studies published in respected peer‐reviewed journals 14–16 …”

“…The present study utilized data from the MHMO, which caters to with data from this source used in numerous studies published in respected peer-reviewed journals. [14][15][16]…”