Outcomes of intraarticular triamcinolone acetonide injection in children with non-systemic juvenile idiopathic arthritis
Issued Date
2023-01-01
Resource Type
ISSN
07703198
eISSN
14349949
Scopus ID
2-s2.0-85149496417
Journal Title
Clinical Rheumatology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Rheumatology (2023)
Suggested Citation
Sukharomana M., Charuvanij S. Outcomes of intraarticular triamcinolone acetonide injection in children with non-systemic juvenile idiopathic arthritis. Clinical Rheumatology (2023). doi:10.1007/s10067-023-06569-w Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82568
Title
Outcomes of intraarticular triamcinolone acetonide injection in children with non-systemic juvenile idiopathic arthritis
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Author's Affiliation
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Abstract
Objectives: The objectives were to explore the response to intraarticular triamcinolone acetonide (TA) injection in children with non-systemic juvenile idiopathic arthritis (JIA) and factors associated with time to arthritis flare. Methods: This was a retrospective cohort study of children with non-systemic JIA who received intraarticular TA injections at a tertiary care hospital in Bangkok, Thailand. Response to intraarticular TA injection was defined as absence of arthritis at 6 months after procedure. Time from joint injection to arthritis flare was recorded. Kaplan–Meier survival analysis with logarithmic rank test and multivariable Cox proportional hazards regression analysis were used for outcome analyses. Results: Intraarticular TA injection was performed in 177 joints among 45 children with non-systemic JIA, most common in the knees (57 joints, 32.2%). Response to intraarticular TA injection at 6 months was observed in 118 joints (66.7%). Ninety-seven joints (54.8%) had arthritis flare following injection. The median time to arthritis flare was 12.65 months (95%CI 8.20–17.10 months). The significant risk factor associated with arthritis flare was the JIA subtypes other than persistent oligoarthritis (HR 2.62, 95%CI 1.085–6.325, p = 0.032); the significant protective factor was concomitant sulfasalazine use (HR 0.326, 95%CI 0.109–0.971, p = 0.044). Adverse effects included pigmentary changes (3, 1.7%) and skin atrophy (2, 1.1%). Conclusion: Intraarticular TA injection in children with non-systemic JIA had favorable response in two thirds of injected joints at 6 months. The JIA subtypes other than persistent oligoarthritis was a predictor of arthritis flare following intraarticular TA injection.Key Points• Intraarticular TA injection in children with non-systemic JIA had a favorable response in two-thirds of injected joints at 6 months.• The median time from intraarticular TA injection to arthritis flare was 12.65 months.• The risk factor predicting arthritis flare was the JIA subtypes other than persistent oligoarthritis (extended oligoarthritis, polyarthritis, ERA, and undifferentiated JIA), while the concomitant use of sulfasalazine was a protective factor.• Local adverse reactions from intraarticular TA injection were less than 2% of injected joints.