Corticosteroids and osteoarthritis progression: a confounded issue

I read with interest the article from Dr Zeng and colleagues investigating the effects of intra-articular corticosteroids (IACs) on osteoarthritis (OA) progression.1 This is a hugely important issue given the paucity of effective pharmacological treatments for OA pain and the need for us to optimise the use of existing therapies with strong analgesic effect sizes, such as IACs. As the authors state, previous in vivo and clinical retrospective studies have raised questions about potential IAC toxicity that remain unanswered.