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Published on: February 25, 2022
Intraarticular triamcinolone in juvenile idiopathic arthritis
1Department of Pediatrics, Dokuz Eylul University Hospital, Division of Immunology and Rheumatology, 35340 Balcova, Izmir, Turkey.
Insights
Intra-articular triamcinolone acetonide injections effectively treat juvenile idiopathic arthritis (JIA) joint inflammation and contractures. Remission rates were highest in oligoarticular JIA, showing this therapy
Area of Science:
- Pediatric Rheumatology
- Orthopedic Surgery
- Pharmacology
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition affecting children's joints.
- Intra-articular corticosteroid injections are a common treatment modality for localized JIA.
- Triamcinolone acetonide (TA) is frequently used for its sustained anti-inflammatory effects.
Purpose of the Study:
- To evaluate the efficacy and safety of intra-articular triamcinolone acetonide (TA) injections in children with JIA.
- To assess remission rates of joint inflammation and success in treating joint contractures.
- To compare treatment outcomes across different subtypes of JIA.
Main Methods:
- Retrospective evaluation of 37 children with JIA receiving one or more intra-articular TA injections.
- Analysis of 125 injections across 95 affected joints.
- Assessment of complete remission of joint inflammation (≥6 months) and treatment of joint contractures.
Main Results:
- Complete remission of joint inflammation was achieved in 65% of injections (62/95) lasting at least 6 months.
- Successful treatment of joint contractures occurred in 69% of joints (35/51).
- Significantly higher remission rates (81%, 21/26) were observed in oligoarticular JIA compared to other subtypes (59%, 41/69; P<0.01).
Conclusions:
- Intra-articular TA injections represent an effective and safe therapeutic option for managing inflammatory joint disease in JIA.
- The oligoarticular subtype of JIA demonstrates a particularly favorable response to intra-articular TA therapy.
- This treatment can lead to sustained joint inflammation remission and improvement in joint contractures.
Abstract:
Thirty seven children with juvenile idiopathic arthritis (JIA) who were treated with one or more intra-articular triamcinolone acetonide (TA) injections were evaluated. Ninety five joints were injected with a total number of 125 injections. Complete remission of the joint inflammation lasting at least 6 months was obtained in 62 of 95 injections (65%). Treatment of the joint contractures was successful in 35 of 51 joints (69%). In patients with oligoarthritis, 21 of 26 injected joints (81%) were in full remission at six-months. The 6-month remission was significantly lower in the other subtypes of JIA (P<0.01), 41 of 69 (59%) injected joints, when compared to oligoarticular patients. Intra-articular TA injection is an effective and safe therapy for inflammatory joint disease in JIA, particularly in the oligoarticular form.
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