Response to treatment with Intra-articular triamcinolone hexacetonide and triamcinolone acetonide in oligo articular Juvenile Idiopathic arthritis
| Autor: | Rabheh Abdul-Aziz, Barbine Tchamba Agbor Agbor, Teresa Hennon, Brian H. Wrotniak, Wajiha Jeelani, Rana Harhay |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Triamcinolone acetonide lcsh:Diseases of the musculoskeletal system Anti-Inflammatory Agents Arthritis Intra-articular corticosteroid (IAC) Gastroenterology Triamcinolone Acetonide Injections Intra-Articular 0302 clinical medicine Joint injection Immunology and Allergy Child medicine.diagnostic_test lcsh:RJ1-570 Oligo-articular juvenile idiopathic arthritis (Oligo JIA) medicine.anatomical_structure Treatment Outcome Erythrocyte sedimentation rate Child Preschool Corticosteroid Female medicine.drug Research Article musculoskeletal diseases medicine.medical_specialty Adolescent medicine.drug_class Triamcinolone acetonide (TA) 03 medical and health sciences Rheumatology Internal medicine Subtalar joint medicine Juvenile Humans Triamcinolone hexacetonide (TH) Glucocorticoids Retrospective Studies 030203 arthritis & rheumatology business.industry Infant lcsh:Pediatrics medicine.disease Arthritis Juvenile Pediatrics Perinatology and Child Health lcsh:RC925-935 business 030217 neurology & neurosurgery |
| Zdroj: | Pediatric Rheumatology Online Journal Pediatric Rheumatology Online Journal, Vol 19, Iss 1, Pp 1-5 (2021) |
| DOI: | 10.21203/rs.3.rs-36966/v2 |
| Popis: | Background Oligo-articular juvenile idiopathic arthritis (Oligo JIA) is the most common subtype of juvenile idiopathic arthritis. Intra-articular corticosteroid (IAC) injection is a mainstay treatment of oligo JIA providing pain relief, improving mobility and preventing further joint destruction in the majority of patients. In 2015, production of triamcinolone hexacetonide (TH) an intra-articular corticosteroid was discontinued in the United States leading to use of triamcinolone acetonide (TA) as an alternative. In this study, we compared response to treatment in children with oligo JIA who underwent therapy with intra-articular TA and TH injection. Methods Our study is a retrospective chart review of children with oligo JIA who were treated with IAC injections with TH between January 2012 and June 2015 and TA between J uly 2015 and December 2018. The two groups were followed at John R. Oishei Children’s Hospital of Buffalo and were evaluated for response to treatment, side effects and predictors of response including duration of disease before treatment, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP). Response to treatment was defined as at least 6 months follow up without evidence of active arthritis in injected joints. Patients were considered to be non-responders if they continued to show active arthritis during their first follow up after joint injection. The primary objective was to evaluate whether there was a significant difference in rate of response between TH and TA. Results Forty-nine patients, 38 female and 11 male with oligo JIA were included in the study. The average age was 6.7 years. A total of 111 joints were injected includin g 78 knees, 13 ankles, 9 wrists, 4 hips, 4 elbows, 2 TMJ and one subtalar joint. In the TA group, 49% (29/59) did not show response to injection compared to 27% (14/52) in the TH group. After 6 months, response rates were better for individuals injected with TH compared to TA (73% vs. 51%). In general, response to intra-articular TH was superior to TA with P = .016 using chi-square test of independence. This difference in outcome was not influenced by other variables such as duration of illness before treatment (P value 0.784) or elevated ESR and CRP. No difference in side effects between the two groups were noted. Conclusion Our results in conjunction with prior published data suggests that TH intra-articular joint injection in oligo JIA is superior to TA, although future controlled trials are necessary for confirmation. An effective, long lasting treatment can have a great impact on the outcome of these children. |
| Databáze: | OpenAIRE |
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