La FDA met en garde sur les dangers des injections épidurales de stéroïdes pour le mal de dos

La Food and Drug Administration vient de publier ce qu’on appelle une «alerte Medwatch» avertissant que les injections de stéroïdes épidurales ou «ESI» pour les douleurs au dos et au cou peuvent être extrêmement dangereuses. L’alerte indique: “L’injection de corticostéroïdes dans l’espace épidural de la colonne vertébrale peut entraîner des effets indésirables rares mais graves, notamment une perte de vision, un accident vasculaire cérébral, une paralysie et la mort.”

Les injections épidurales de stéroïdes – et leurs blessures catastrophiques – ont fait l’objet de ma première enquête pour  The Dr. Oz Show il ya  presque exactement un an. (Vous pouvez visionner la vidéo ici et lire l’article Web ici.) L’espace épidural est un espace situé entre la moelle épinière et la structure osseuse de la colonne vertébrale.

Notre enquête a révélé que les stéroïdes – appelés corticostéroïdes – utilisés pour les injections épidurales ne sont même pas approuvés par la FDA à cette fin. Pourtant, les ESI sont effectuées près de 9 millions de fois par an, selon une analyse du Dr Laxmaiah Manchikanti.

En plus d’informer le public via son alerte Medwatch, la FDA a déclaré: «Nous avons besoin de l’ajout d’un  avertissement  aux étiquettes de médicaments des corticostéroïdes injectables pour décrire ces risques.» Les corticostéroïdes injectables comprennent la méthylprednisolone, l’hydrocortisone, la triamcinolone, la bétaméthasone et la dexaméthasone. .

Le nouvel avertissement rappellera plus clairement aux médecins que l’injection de stéroïdes dans l’espace épidural, juste à l’extérieur de la moelle épinière, comporte des risques. Mais l’avertissement n’a pas énuméré toutes les réactions indésirables possibles. Ces réactions sont nommées en petits caractères sur les étiquettes des médicaments actuels et comprennent: «arachnoïdite, dysfonctionnement des intestins / de la vessie, maux de tête, méningite, paraparésie / paraplégie, convulsions, troubles sensoriels».

En 2009, la FDA a réuni un groupe chargé d’étudier la sécurité de certains types d’injections de stéroïdes épidurales. Dans son nouvel avis, la FDA a déclaré que les recommandations du groupe n’étaient toujours pas prêtes et qu’elles seraient publiées quand elles le seraient.

Dennis Capolongo de l’EDNC, un groupe qui milite depuis des années contre les injections épidurales de stéroïdes, a qualifié le nouvel avertissement de la FDA de «douxbon amer», car il ne va pas plus loin. Capolongo veut que la FDA aille plus loin que de dire aux médecins que l’injection de stéroïdes dans l’espace épidural POURRAIT avoir des effets secondaires graves, mais plutôt qu’elle NE DOIT PAS le faire.

En février de cette année, les autorités sanitaires australiennes et néo-zélandaises ont publié ce langage plus précis, affirmant que les stéroïdes de ce type “NE DOIVENT PAS être utilisés par les voies intrathécale, épidurale, intraveineuse ou toute autre voie non spécifiée”. Le gouvernement sud-africain a publié avertissements similaires, selon Capolongo.

Étant donné que la FDA étudie toujours activement ces procédures, il sera intéressant de voir si l’agence prend d’autres mesures. Si et quand cela se produit, vous pouvez parier que je transmettrai l’information.


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