Background/Purpose: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood. Intra-articular corticosteroids joint injection (IAJI) with Triamcinolone hexacetonide (TH) or triamcinolone acetonide (TA) is considered as the first-line therapy for oligoarticular JIA. Previous studies showed benefit of TH vs. TA; however TA is still used in most of Israeli pediatric rheumatology centers. Our unit has experience with both regimens and therefore we aimed to compare the efficacy and safety of TA versus TH for JIA patient.

Methods: Chart review of JIA patients who were randomly (based on drug availability) treated with TA or TH IAJI between 2010-2019 was conducted. Primary outcome for efficacy was defined as full recovery of arthritis one month after IAJI and recurrence of arthritis 3 months month after IAJI. Primary outcome for safety was defined as the occurrence of adverse events (AEs) one month after IAJI.

Results: Overall 292 joints of 102 JIA patients were treated (138 TA/154 TH joints). Complete recovery after one month was documented in 107 (69.6%) TA treated joints and 96 (69.5%) TH treated joints (P=0.232). However, rate of relapse after 3 months was significantly higher in TA treated joints [27 (20.1%) vs. 13 (8.8%); (P< 0.01)]. No AEs were documented except of minor scar at 2 joints injection sites.

Conclusion: Although arthritis recovery was similar (~70%) with both regimens, relapse rate was more than doubled in TA injected joints vs. TH. These findings are specifically important due to contemporary shortage of TH in the US market.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/long-term-efficacy-and-safety-of-triamcinolone-hexacetonide-versus-triamcinolone-acetonide-intraarticular-injection-for-juvenile-idiopathic-arthritis/