Triamcinolone hexacetonide 100mg/5ml suspension for injection vials

PurposeThe purpose of this study was to quantify and compare the clinical relevance of the different intra-articular corticosteroids (CS) effects in vivo for osteoarthritis (OA) treatment.MethodsThe search was conducted on PubMed, Cochrane, and Web of Science in October 2023. The PRISMA guidelines were used. Inclusion criteria: animal or human randomized controlled trials (RCTs), English language and no time limitation, on the comparison of different intra-articular CS for OA treatment. The articles' quality was assessed using the Cochrane RoB2 and GRADE guidelines for human RCTs, and SYRCLE's tool for animal RCTs.ResultsEighteen RCTs were selected (16 human and 2 animal studies), including 1577 patients (1837 joints) and 31 animals (51 joints). The CS used were triamcinolone (14 human and 2 animal studies), methylprednisolone (7 human and 1 animal study), betamethasone (3 human studies) and dexamethasone (1 human study). All studies addressed knee OA except for three human and one animal study. A meta-analysis was performed on the comparison of methylprednisolone and triamcinolone in humans with knee OA analysing VAS pain at very short- (≤2 weeks), short- (>2 and ≤4 weeks), mid- (>4 and ≤8 weeks), long- (>8 and ≤ 12 weeks), and very long-term (>12 and ≤24 weeks). Triamcinolone showed better post-injection values compared to methylprednisolone at very short-term (p = 0.028). No difference in terms of VAS improvement was observed at any follow-up.ConclusionsThe available preclinical and clinical literature provides limited evidence on the comparison of different CS, hindering the possibility of determining the best CS approach in terms of molecule and dose for the intra-articular injection of OA joints.Level of evidenceLevel I.

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IntroductionJuvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and steroid intra-articular injections are a fundamental treatment modality among local therapeutic interventions. The aim of this systemic review was to assess the scientific evidence on the effectiveness and safety of intra-articular corticosteroids (IACS) injections, focusing on a comparative examination of the different therapeutic options.Material and methodsPubMed, Scopus, and Web of Science were systematically searched from the inception until February 25, 2025, to identify observational studies presenting participants with a diagnosis of JIA, IACS injections for joints affected by arthritis as interventions, and clinical or radiological assessment of arthritis as outcomes.ConclusionsFindings from this systematic review suggested that IACS injections might be effective in improving arthritis in patients affected by JIA, with good evidence of safety. Moreover, the review underlines a higher efficacy of triamcinolone hexacetonide among corticosteroids used for injections. Further studies with a higher level of evidence and more representative samples should be conducted.  What is Known: • Juvenile idiopathic arthritis is the most prevalent chronic rheumatic condition in childhood and represents a major cause of disability. • The management of juvenile idiopathic arthritis involves a variety of therapeutic modalities, among which intra-articular corticosteroid injections.What is new• Intra-articular corticosteroid injections induce rapid symptom control and prolonged remission in a substantial proportion of patients. • Among different types of corticosteroids, triamcinolone hexacetonide is more effective in prolonging remission duration in JIA.

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