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Comparative Study
. 2022 Jan 29;20(1):5.
doi: 10.1186/s12969-022-00666-x.

The efficacy and safety of intra-articular injection of triamcinolone acetonide versus triamcinolone hexacetonide for treatment of juvenile idiopathic arthritis

Shiri Rubin  1   2 , Orly Ohana  2   3 , Ori Goldberg  2   4 , Orit Peled  5 , Yulia Gendler  6 , Zohar Habot-Wilner  2   7 , Yoel Levinsky  2   8 , Rotem Tal  2   9 , Liora Harel  2   9 , Gil Amarilyo  10   11
Affiliations
Comparative Study

The efficacy and safety of intra-articular injection of triamcinolone acetonide versus triamcinolone hexacetonide for treatment of juvenile idiopathic arthritis

Shiri Rubin et al. Pediatr Rheumatol Online J. .

Abstract

Objectives: Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease. Intra-articular corticosteroids joint injection (IAJI), with triamcinolone hexacetonide (TH) or triamcinolone acetonide (TA), is an effective additional treatment for oligo and polyarticular JIA. Previous studies have shown the benefits of TH over TA; however, TA is still used in many pediatric rheumatology centers. Our unit has experience with both regimens, and therefore we aimed to compare the efficacy and safety of TA versus TH for JIA patients.

Methods: Chart review of JIA patients who were randomly (based on drug availability) treated with TA or TH IAJI during 2010-2019. Primary outcomes for efficacy were defined as full recovery from arthritis one month after IAJI and a relapse rate of arthritis 3 months after IAJI. Primary outcome for safety was defined as the occurrence of adverse events (AEs) during the follow up period after IAJI.

Results: Overall, 292 joints of 102 JIA patients were treated (138 TA/154 TH joints). Complete recovery after one month was documented in 107 (69.6%) of TA treated joints and 96 (69.5%) of TH treated joints (P = 0.232). However, rate of relapse after 3 months was significantly higher for TA treated joints (27 (20.1%) vs. 13 (8.8%), respectively, P < 0.01). No AEs were documented except minor scars at four joint injection sites.

Conclusion: The recovery from arthritis was similar (~ 70%) with both regimens, however relapse rate was more than double in TA as compared to TH injected joints. These findings are important due to a contemporary shortage of TH in the US market.

Keywords: Intra-articular corticosteroids; Juvenile idiopathic arthritis; Triamcinolone.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meyer analysis of relapse rates in both treatment groups (P = 0.02, log rank test) TA - Triamcinolone acetonide; TH - Triamcinolone hexacetonide
See this image and copyright information in PMC

References

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