Triamcinolone hexacetonide 20mg/1ml suspension for injection ampoules

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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Needle-free jet injectors are used for the intralesional treatment of various dermatological indications. However, a systematic review that evaluates the efficacy and safety of these treatments has not been published. The objectives of this study are to evaluate the efficacy and safety of needle-free jet injections for dermatological indications and to provide evidence-based treatment recommendations. An electronic literature search was conducted in April 2022. Two reviewers independently selected studies based on predefined criteria and performed a methodological quality assessment using the Cochrane Collaborations risk-of-bias 2.0 assessment tool and Newcastle-Ottawa Scale. Thirty-seven articles were included, involving 1911 participants. Dermatological indications included scars, alopecia areata, hyperhidrosis, nail diseases, non-melanoma skin cancer, common warts, local anesthesia, and aesthetic indications. Keloids and other types of scars (hypertrophic, atrophic, and burn scars) were investigated most frequently (n = 7). The included studies reported favorable efficacy and safety outcomes for intralesional jet injector-assisted treatment with triamcinolone acetonide/hexacetonide, 5-fluorouracil, bleomycin, or hyaluronic acid. Two high-quality studies showed good efficacy and tolerability of intralesional jet injections with a combination of 5-fluorouracil and triamcinolone acetonide in hypertrophic scars and with saline in boxcar and rolling acne scars. No serious adverse reactions and good tolerability were reported in the included studies. Overall, the methodological quality of the included studies was low. Limited evidence suggests that needle-free jet injector-assisted intralesional treatment is efficacious and safe for hypertrophic and atrophic acne scars. More well-powered RCTs investigating the efficacy and safety of jet injector treatment in dermatology are warranted to make further evidence-based recommendations.

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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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ABSTRACT Background: Adhesive capsulitis (AC) is an idiopathic glenohumeral joint disease resulting in pain, stiffness, and global restriction of all movements without radiological change, which can negatively impact activities of daily living and lower quality of life. Objective: To compare the effectiveness of ultrasound-guided intra-articular injection of platelet-rich plasma (PRP) with triamcinolone hexacetonide in improving pain and function in patients with AC. Materials and Methods: A randomized controlled trial was conducted in the Department of Physical Medicine and Rehabilitation in a tertiary care hospital in Imphal, Manipur, India. A total of 64 patients were randomized to receive either ultrasound-guided single-dose intra-articular injection of PRP (study group) or triamcinolone hexacetonide 20 mg (control group). Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), and passive range of motion (PROM) were assessed. Follow-up was done at 1, 4, 12, and 24 weeks postintervention. Range of motion and stretching exercises were advised in both groups postintervention. Results: Both groups showed significant statistical improvement in VAS, SPADI, and PROM scores from baseline to all subsequent follow-ups (P < 0.05). However, PROM did not reveal statistically significant differences in the subsequent follow-ups except for flexion. Conclusion: Single-dose intra-articular injection of PRP improves pain and function in AC of the shoulder but the comparison between the two groups indicated statistically significant improvement in pain and function measured by VAS and SPADI in the steroid group in all the follow-ups.

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