Efficacy and safety of intra-articular injection with triamcinolone acetonide for patients with rheumatoid arthritis

Background Intra-articular injection (IAI) with a glucocorticoid (GC) is often used in clinical practice, despite its controversial effectiveness. We performed a retrospective study that evaluated the efficacy and safety of IAI with the GC triamcinolone acetonide (TA) in patients with rheumatoid arthritis (RA) over the period of April 2014-March 2019. Methods Clinical indices 1 month and 1 year after the initial TA IAI were compared statistically. Changes in disease activity scores (DAS) and correlation between DAS and background factors were evaluated for each time period. Clinical indices, pain index, joint deformity index, bone mineral density ( BMD), and changes in each parameter up to 1 month and 1 year after the initial IAI were compared between patient groups classified according to the number of IAIs per year. The DAS in patients who had received TA IAIs was compared with the DAS in patients who had received sodium hyaluronate (SH) IAIs. Results In total, 1010 IAIs were performed in 208 patients. All components of the simplified disease activity index, as well as pain scores, significantly decreased at 1 month and 1 year after the initial IAI (p < 0.01). The higher the frequency of IAIs, the greater the prevalence of adverse events (AEs), the most frequent of which were gastrointestinal disorders. The DAS improved to a greater extent with TA than with SH. Conclusion IAI is a useful therapeutic strategy in terms of controlling disease activity and managing pain; however, the frequency of IAI should be considered due to the increased risk of AEs with frequent administration.