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Efficacy and safety of intra-articular injection with triamcinolone acetonide for patients with rheumatoid arthritis

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Abstract

Background

Intra-articular injection (IAI) with a glucocorticoid (GC) is often used in clinical practice, despite its controversial effectiveness. We performed a retrospective study that evaluated the efficacy and safety of IAI with the GC triamcinolone acetonide (TA) in patients with rheumatoid arthritis (RA) over the period of April 2014–March 2019.

Methods

Clinical indices 1 month and 1 year after the initial TA IAI were compared statistically. Changes in disease activity scores (DAS) and correlation between DAS and background factors were evaluated for each time period. Clinical indices, pain index, joint deformity index, bone mineral density (BMD), and changes in each parameter up to 1 month and 1 year after the initial IAI were compared between patient groups classified according to the number of IAIs per year. The DAS in patients who had received TA IAIs was compared with the DAS in patients who had received sodium hyaluronate (SH) IAIs.

Results

In total, 1010 IAIs were performed in 208 patients. All components of the simplified disease activity index, as well as pain scores, significantly decreased at 1 month and 1 year after the initial IAI (p < 0.01). The higher the frequency of IAIs, the greater the prevalence of adverse events (AEs), the most frequent of which were gastrointestinal disorders. The DAS improved to a greater extent with TA than with SH.

Conclusion

IAI is a useful therapeutic strategy in terms of controlling disease activity and managing pain; however, the frequency of IAI should be considered due to the increased risk of AEs with frequent administration.

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Authors and Affiliations

  1. Department of Rheumatology and Musculoskeletal Medicine, Yoshii Hospital, 6-7-5 Nakamura-Ohashidori, Shimanto, Kochi, 787-0033, Japan

    Ichiro Yoshii

  2. Department of Rheumatology, Dohgo SPA Hospital, 21-21 Otsu Himetsuka, Matsuyama, Ehime, 790-0858, Japan

    Naoya Sawada

Authors
  1. Ichiro Yoshii
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Contributions

IY analyzed and interpreted the data used in this study, and NS checked the results and read the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ichiro Yoshii.

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Funding

The authors declare that no funding was received for this study.

Conflict of interest

Ichiro Yoshii and Naoya Sawada have no conflicts of interest to declare relevant to the contents of this article.

Ethics approval and consent to participate

This study was approved by our institution’s Ethics Committee (approval number Y-RA-2019-5) in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. In addition, anonymity was ensured for all patients and their families who participated in this study, and no names and/or addresses were issued that could help identify these individuals. Moreover, all patients were informed of the purpose and possible consequences of this study (i.e. that this was a retrospective study in clinical practice without any experimentation on subjects).

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Yoshii, I., Sawada, N. Efficacy and safety of intra-articular injection with triamcinolone acetonide for patients with rheumatoid arthritis. Drugs Ther Perspect 36, 404–412 (2020). https://doi.org/10.1007/s40267-020-00755-5

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  • DOI: https://doi.org/10.1007/s40267-020-00755-5

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