Outcome and predicting factors of single and multiple intra-articular corticosteroid injections in children with juvenile idiopathic arthritis

Stefano Lanni, Marta Bertamino, Alessandro Consolaro, Angela Pistorio, Silvia Magni-Manzoni, Roberta Galasso, Bianca Lattanzi, Enrique Calvo-Aranda, Alberto Martini, Angelo Ravelli

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To investigate the efficacy of IA CS (IAC) therapy in single and multiple joints in children with JIA and to seek for predictors of synovitis flare. Methods: The clinical charts of patients who received their first IAC injection between January 2002 and December 2008 were reviewed. The CS used was triamcinolone hexacetonide for large joints and methylprednisolone acetate for small or difficult to access joints. Patients were stratified as follows: one joint injected; two joints injected; and three or more joints injected. Predictors included sex, age at disease onset, JIA category, age and disease duration, ANA status, iridocyclitis, general anaesthesia, number and type of injected joints, acute-phase reactants and concomitant MTX therapy. Results: The cumulative probability of survival without synovitis flare for patients injected in one, two, or three or more joints was 70, 45 and 44%, respectively, at 1 year; 61, 32 and 30%, respectively, at 2 years; and 37, 22 and 19%, respectively, at 3 years. On Cox regression analysis, positive CRP, negative ANA and injection in the ankle were the strongest predictors for synovitis flare. The only significant side effect was skin hypopigmentation or s.c. atrophy, which occurred in

Original languageEnglish
Article numberker165
Pages (from-to)1627-1634
Number of pages8
JournalRheumatology
Volume50
Issue number9
DOIs
Publication statusPublished - Sep 2011

Keywords

  • Intra-articular corticosteroids
  • Intra-articular injection
  • Juvenile idiopathic arthritis
  • Triamcinolone hexacetonide.

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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