Steroid Shots Stay Popular Despite Meningitis Outbreak

Taking Big Risk for Pain Relief

The Wall Street Journal—October 18, 2012

James Chamberlain, who has been getting steroid injections for the past five years to treat his debilitating back pain, had recently begun a new round of them when he heard such shots have been tied to a deadly fungal-meningitis outbreak.

He decided to continue with the treatment anyway, getting his latest injection Thursday. "If I didn't have the epidural shots, I'd be quite miserable and quite lame," said Mr. Chamberlain, 59 years old, of Forest Hills, N.Y.

Clinics and surgical centers that offer such injections say they are fielding a flood of patient questions about safety in the wake of the meningitis outbreak.

Clinics are turning to alternatives to replace the steroid supplied by New England Compounding Center, the Massachusetts drug-mixing pharmacy that has recalled its products and stopped operating amid a government investigation. Some clinics say they are buying steroids from traditional drug makers, but others say they are also turning to rival compounders as other players in the market push to fill the void. Compounding pharmacies custom-mix medicines but aren't regulated like traditional drug makers.

Pain clinics turned to compounders to fill the void in part because their version of the steroid is free of the preservatives used by pharmaceutical companies that can help guard against fungal growth, in addition to extending shelf life.

At Hospital for Special Surgery in New York City, Seth Waldman, Mr. Chamberlain's doctor, said many patients have called or emailed asking about who supplies its steroid injections. He tells them the hospital buys them from pharmaceutical companies including Bristol-Myers Squibb Co., not compounding pharmacies. "There's not been too much of a drop-off, but people are understandably worried," said Dr. Waldman, director of the hospital's pain-management division.

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