Effectiveness of intra-articular injection in wrist joints according to triamcinolone hexacetonide dose in rheumatoid arthritis: a randomized controlled double-blind study.

The aim of this study was to compare the effectiveness in the medium term between low and high doses of triamcinolone hexacetonide used in intra-articular injection in medium-sized joints of rheumatoid arthritis (RA) patients.
A randomized double-blind study was carried out in rheumatoid arthritis patients with wrist painful refractory synovitis. Sixty wrists were included and randomized to receive low dose (20 mg) or high dose (40 mg). The outcomes assessed in T0, T1, T4, T8, and T12 weeks were visual analog scale for pain and for swelling, chronic disease activity index, goniometry, simplified Stanford Health Assessment Questionnaire, and side effects.
Baseline mean (standard deviation) values were pain visual analog scale of 6.1 (1.6) and 6.3 (1.7), P = 0.562; swelling visual analog scale of 5.9 and 6.4, P = 0.466; chronic disease activity index of 17.8 and 16.8, P = 0.366; and Health Assessment Questionnaire of 0.8 and 0.7, P = 0.238, in the high- and low-dose groups, respectively. Both groups improved pain and swelling assessed by the visual analog scale, P < 0.001, in the intragroup analysis. Chronic disease activity index, goniometry, and Health Assessment Questionnaire also improved equally over time in both groups in the intragroup analysis (P < 0.001, 0.001, and 0.002, respectively). No serious side effects were detected.
High and low triamcinolone hexacetonide doses had good effectiveness in wrist-blinded intra-articular injection of rheumatoid arthritis patients, without statistical difference between them.
AuthorsDaniele Freitas Pereira, Jamil Natour, Natália Pereira Machado, Rita Nely Vilar Furtado
JournalAmerican journal of physical medicine & rehabilitation / Association of Academic Physiatrists (Am J Phys Med Rehabil) Vol. 94 Issue 2 Pg. 131-8 (Feb 2015) ISSN: 1537-7385 [Electronic] United States
PMID25171663 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Inflammatory Agents
  • Triamcinolone Acetonide
  • triamcinolone hexacetonide
  • Adult
  • Anti-Inflammatory Agents (administration & dosage)
  • Arthritis, Rheumatoid (complications, drug therapy)
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Pain Measurement
  • Synovitis (drug therapy, etiology)
  • Treatment Outcome
  • Triamcinolone Acetonide (administration & dosage, analogs & derivatives)
  • Wrist Joint

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