SAT0250 The dosing of intra-articular triamcinolone hexacetonide for knee synovitis in chronic polyarthritis – a randomized controlled study

Background: Intra-articular glucocorticoid (IAGC) injection treatment is an easy and effective way to treat signs and symptoms of arthritis and it has been used for decades. Serious adverse reactions are rare, but IAGC therapy has impact on endocrine balances. There is limited knowledge of the adequate dosing for different joints and dosing traditions vary all over world. Objectives: To compare the relapse rate during 6 months after IAGC for knee synovitis, between two common doses (20 mg vs 40 mg) of triamcinolone hexacetonide (THA). Methods: A total of 159 adult patients with rheumatoid arthritis (RA) or psoriatic arthritis (Psoa) and active knee synovitis were randomized to IAGC injection with either 20 mg or 40 mg THA blinded to the participants. The primary endpoint was relapse of arthritis. When symptoms from the treated joint recurred and signs of arthritis could be confirmed on a following clinical examination a relapse was recorded and days from injection to relapse was calculated. At the end of the observation period those without relapse had a phone call to verify persistence of good treatment response. Results: In this material there was no significant difference in patient characteristics at baseline and the proportion of relapse after 6 months were equal in the treatment arms (30% versus 32%, p=0.822). Additionally no significant differences were found in the subgroups with RA and Psoa patients. Conclusions: To reduce the risk for endocrine side effects and as no difference in treatment outcome between the compared doses was found the lower 20 mg THA dose should be preferred in IAGC treatment for knee synovitis in chronic polyarthritis. Disclosure of Interest: None declared