Pharmacology of intra-articular triamcinolone

被引:32
|
作者
Scherer, Justin [1 ]
Rainsford, K. D. [2 ]
Kean, Colin A. [3 ]
Kean, Walter F. [4 ,5 ]
机构
[1] McMaster Univ, Fac Life Sci, Hamilton, ON L8S 4K1, Canada
[2] Sheffield Hallam Univ, Biomed Res Ctr, Sheffield S1 1WB, S Yorkshire, England
[3] Univ Vita Salute, Milan, Italy
[4] McMaster Univ, Fac Hlth Sci, Dept Med Rheumatol, Hamilton, ON L8S 4K1, Canada
[5] McMaster Univ, Hamilton, ON L8N 1T8, Canada
关键词
Triamcinolone; Intra-articular therapy; Pharmacokinetics; Pharmacodynamics; JUVENILE IDIOPATHIC ARTHRITIS; ENDOTHELIAL GROWTH-FACTOR; GLUCOCORTICOID-RECEPTOR; CORTICOSTEROID INJECTION; RHEUMATOID-ARTHRITIS; DOUBLE-BLIND; OSTEOPROTEGERIN LIGAND; MOLECULAR-MECHANISMS; I ETIOLOGY; KNEE;
D O I
10.1007/s10787-014-0205-0
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The inflammatory joint diseases of juvenile inflammatory arthritis (JIA), rheumatoid arthritis (RA) and osteoarthritis (OA): and also mild to moderate joint injury, all require a multidisciplinary approach to management. Intra-articular injections of corticosteroids have been shown to be a very beneficial adjunctive treatment in the management of the above disorders. It is, therefore, important that clinicians have a good understanding of the clinical actions of intra-articular injections. This article explores the pharmacokinetics, pharmacodynamics, and clinical pharmacology of triamcinolone acetonide (TA) and triamcinolone hexacetonide (TH) in JIA, RA, and OA. Literature search of TA and TH articles was conducted using key word searches in the PubMed and Google Scholar databases and through references within found articles. TA and TH intra-articular injections have been shown to provide good clinical benefit for up to 6 months and even longer. TH has been shown to decrease in the expression of citrullinated proteins, the monoclonal antibody F95, and peptidylarginine deiminase 4 in RA synovium. TA and TH intra-articular injections have a low side effect profile which is similar to other corticosteroid. They have minimal to no mineralocorticoid adverse effects and facial flushing 2-3 days post injections is the most common side effect recorded, and in almost all cases is no worse than nuisance. TA and TH are useful adjunct therapies in the management of JIA, RA, OA, and mild to moderate joint injury.
引用
收藏
页码:201 / 217
页数:17
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