Pediatric Rheumatology Online Journal → June 2003 → Medical Treatment → Intra-articular steroids→ Abstract #61
A COMPARISON OF INTA-ARTICULAR STEROIDS IN JRA AND SPONDYLOARTHRITIS
R. M. Sheets,1 I. Szer.1
1Pediatric Rheumatology, Children
Introduction: the effect of steroid injections for children with various types of arthritis is not well known.
Methods: 46 children received Aristospan (53 joints) or Kenalog (35 joints), 1 mg/kg per large joint and were followed for 1-67 months (mean 22 mo
Results: 10/22 children with pauci JRA who received Aristospan and 9/13 treated with Kenalog , remitted completely,. The remaining 12 joints treated with Aristospan relapsed after 3 to 21 months. Of the remaining 4 Kenalog injected patients, 2 had no significant response, 1 was lost to follow up, and 1 relapsed 6 months later. Of the polyarticular group treated with Aristospan, 5/16 completely remitted, compared to 3/9 in the Kenalog group, but follow up of all 3 is less than 3 months. Of the remaining Aristospan treated polyarticular patients, 3 failed to respond, 1 was lost to follow up, and 7 relapsed after 4 to 15 months. Of the remaining Kenalog treated polyarticular patients 6 relapsed within 2-9 months. Of the systemic JRA group treated with Aristospan, 2/5 remitted, 3/5 relapsed after 7 to 10 months. None of the Kenalog group remitted, 1/5 failed to respond, and 4/5 relapsed after 3 to 10 months. Of the spondyloarthritis patients treated with Aristospan 2/4 remitted, one did not respond, and one relapsed in two months, compared to 2/2 of the Kenalog patients whose follow up is only 3 and 5 months. Of the psoriatic arthritis patients treated with Aristospan, 4/6 remitted and the other 2/6 relapsed at 3 and 20 months. Of the two Kenalog treated psoriatic joints, 1 was lost to follow up and 1 relapsed 13 months later.
Conclusions: Our data confirm the efficacy of intra-articular joint injections. A longer follow up time will be needed to compare the two drugs for duration of effectiveness. Ongoing studies will elucidate which patients are best candidates for intra-articular injections and whether or not concomitant medications influence duration of response.