INTRAARTICULAR STEROIDS IN TREATMENT OF JUVENILE IDIOPATHIC ARTHRITIS: A SINGLE CENTER EXPERIENCE

Aim: To evaluate the therapeutic response to triamcinolone acetonide (TA) and triamcinolone hexacetonide (TH) injections in the knee of children with JIA. Material and methods : 46 joints of 42 children undergoing intra-articular injections were randomly treated with either TH or TA depending on the availability of the drug. A good response was defined as the decrease in articular score of 60% from the baseline and the ultrasound absence of synovitis. Clinical, laboratory variables were noted to examine possible predictive factors of the result. Results : Of 42 children with JIA, the most common was the oligoarticular persistent form in 24 (57.1%) children. Six-month remission was observed in 21.4 % of children, TA vs. TH: 36.8% vs. 8.7% (p=0.02). The absence of signs of knee inflammation within 12 months was found in 23.8% of children, after the application of TA vs. TH: 31.6% vs. 17.4% (p=0.28). However, long-term, a twenty-four-month remission was achieved in 52.4% of children – in twice as many children after TH (69.9%) than after TA application (31.6%) (p=0.03).  A statistically significant correlation was observed between articular score values and duration of remission after TH application, (r=0.56, p=0.006; 95%CI: 0.145-0.80). Two children developed side effects in the form of subcutaneous atrophy at the site of injection, one girl developed transient crystal synovitis after TH applications. Conclusion: This study has shown that intraarticular steroid injections are safe for the treatment of joint inflammation in JIA,and TA is effective in short-term follow-up where TH is an optimum choice in long-term follow-up.