Department of Pediatric Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
Department of Pediatric Rheumatology, Etlik City Hospital, Ankara, Turkey.
Postgrad Med. 2024 Nov;136(8):883-889. doi: 10.1080/00325481.2024.2412969. Epub 2024 Oct 9.
Juvenile idiopathic arthritis (JIA) is a common chronic rheumatic disease in children, requiring careful management to reduce both short- and long-term morbidity. In this study, our objective was to assess the clinical features of patients diagnosed with JIA who received intra-articular corticosteroid injections (IACI).
In this retrospective study, we evaluated the clinical and laboratory characteristics of 225 JIA patients monitored from January 2012 to October 2023 at a tertiary care center. We focused on patients who underwent intra-articular corticosteroid injections (IACI) as part of their treatment. Triamcinolone hexacetonide (TH) was used due to its demonstrated safety and efficacy.
Our analysis revealed that IACI, particularly utilizing TH, was a widely employed and effective adjunct therapy, contributing to rapid symptom relief and local disease control. Patients receiving IACI exhibited earlier symptom onset, younger age at diagnosis, longer follow-up durations, and higher cumulative treatment burden ( < 0.001, < 0.001, < 0.01, < 0.001 respectively). Despite inconclusive acute-phase reactants, a higher frequency of ANA positivity and elevated initial lymphocyte counts were associated with increased IACI use ( < 0.001, < 0.001 respectively). Importantly, on a joint basis, a high percentage of arthritis remission following IACI underscores its efficacy and favorable safety profile.
Notably, the high percentage of arthritis remission achieved with intra-articular corticosteroid injections (IACI) on a joint-specific basis highlights its efficacy and favorable safety profile. A lymphocyte count exceeding 5000/mm at the time of diagnosis may serve as an early indicator for considering intra-articular steroid administration. These findings emphasize the need for nuanced and individualized treatment strategies in JIA management to optimize outcomes for affected children.
幼年特发性关节炎（JIA）是儿童常见的慢性风湿性疾病，需要精心管理以降低短期和长期发病率。在这项研究中，我们的目的是评估接受关节内皮质类固醇注射（IACI）治疗的 JIA 患者的临床特征。
在这项回顾性研究中，我们评估了 2012 年 1 月至 2023 年 10 月在一家三级护理中心监测的 225 名 JIA 患者的临床和实验室特征。我们专注于接受关节内皮质类固醇注射（IACI）作为其治疗一部分的患者。由于三氯乙酸己烷（TH）的安全性和有效性已得到证实，因此使用了它。
我们的分析表明，IACI，特别是使用 TH，是一种广泛使用且有效的辅助治疗方法，有助于迅速缓解症状和局部疾病控制。接受 IACI 的患者发病更早，诊断时年龄更小，随访时间更长，累积治疗负担更高（<0.001，<0.001，<0.01，<0.001 分别）。尽管急性期反应物不确定，但 ANA 阳性率较高和初始淋巴细胞计数升高与 IACI 使用增加相关（<0.001，<0.001 分别）。重要的是，从关节的角度来看，IACI 后关节炎缓解的比例较高，这突出了其疗效和良好的安全性。
值得注意的是，关节内皮质类固醇注射（IACI）在关节特异性基础上实现的关节炎缓解率较高，突出了其疗效和良好的安全性。诊断时淋巴细胞计数超过 5000/mm 可能是考虑关节内类固醇给药的早期指标。这些发现强调了在 JIA 管理中需要制定细致和个体化的治疗策略，以优化受影响儿童的结局。
