Retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritis
Background. Despite the progress in diagnosis and treatment of chronic rheumatic diseases in children, the choice of anti-inflammatory drugs in case of the onset of oligoarticular juvenile idiopathic arthritis (JIA) still remains relevant. Till present, pediatric rheumatologists have not reached a ...
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Siberian State Medical University (Tomsk)
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doaj-55245f15841646a699d8fe69663d7aa22021-07-29T08:38:09ZengSiberian State Medical University (Tomsk)Bûlleten' Sibirskoj Mediciny1682-03631819-36842021-07-01202546410.20538/1682-0363-2021-2-54-642780Retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritisA. N. Kozhevnikov0N. A. Pozdeeva1M. S. Nikitin2O. N. Maricheva3T. V. Murashko4N. Yu. Orlova5S. L. Bogdanova6G. A. Novik7H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; Saint-Petersburg State Pediatric Medical UniversityH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgerySaint-Petersburg State Pediatric Medical UniversityBackground. Despite the progress in diagnosis and treatment of chronic rheumatic diseases in children, the choice of anti-inflammatory drugs in case of the onset of oligoarticular juvenile idiopathic arthritis (JIA) still remains relevant. Till present, pediatric rheumatologists have not reached a consensus on this issue yet.The aim of this study was to search for predictors of early failure of local steroid therapy and assessment of its feasibility in patients with oligoarticular JIA.Materials and methods. In a retrospective study, 92 children aged 11 months – 9 years with chronic oligoarticular JIA without extra-articular manifestations were monitored. The features of the clinical, instrumental and laboratory diagnosis during the disease onset were studied, along with the dynamics of the articular syndrome and the effectiveness of intra-articular administration of corticosteroid drugs.Results and discussion. The data on 92 children with 164 active joints who received 218 local intra-articular injections of triamcinolone acetonide at the onset of the disease were analyzed. Intra-articular injections of triamcinolone acetonide at a dose of 20–40 mg were performed with an interval of 3, 6, and 12 months, depending on the intensity of the disease. In about one third of children with oligoarticular JIA, arthritis became inactive on average after two intra-articular injections of triamcinolone acetonide. The study did not reveal the predictors of early ineffective topical corticosteroid monotherapy in children. No clinical, instrumental, and laboratory signs were identified that would directly indicate the need for early therapy with methotrexate.Conclusion. Triamcinolone acetonide is an effective and safe drug for children with oligoarticular JIA. Despite the widespread use of biological, gene, and other innovative therapies, application of local corticosteroids as the firstline therapy in children with oligoarticular JIA should not be neglected.https://bulletin.tomsk.ru/jour/article/view/4377oligoarticular juvenile idiopathic arthritislocal steroid therapytriamcinolone acetonide |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
A. N. Kozhevnikov N. A. Pozdeeva M. S. Nikitin O. N. Maricheva T. V. Murashko N. Yu. Orlova S. L. Bogdanova G. A. Novik |
spellingShingle |
A. N. Kozhevnikov N. A. Pozdeeva M. S. Nikitin O. N. Maricheva T. V. Murashko N. Yu. Orlova S. L. Bogdanova G. A. Novik Retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritis Bûlleten' Sibirskoj Mediciny oligoarticular juvenile idiopathic arthritis local steroid therapy triamcinolone acetonide |
author_facet |
A. N. Kozhevnikov N. A. Pozdeeva M. S. Nikitin O. N. Maricheva T. V. Murashko N. Yu. Orlova S. L. Bogdanova G. A. Novik |
author_sort |
A. N. Kozhevnikov |
title |
Retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritis |
title_short |
Retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritis |
title_full |
Retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritis |
title_fullStr |
Retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritis |
title_full_unstemmed |
Retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritis |
title_sort |
retrospective analysis of the effectiveness of local corticosteroid therapy in children with oligoarticular juvenile idiopathic arthritis |
publisher |
Siberian State Medical University (Tomsk) |
series |
Bûlleten' Sibirskoj Mediciny |
issn |
1682-0363 1819-3684 |
publishDate |
2021-07-01 |
description |
Background. Despite the progress in diagnosis and treatment of chronic rheumatic diseases in children, the choice of anti-inflammatory drugs in case of the onset of oligoarticular juvenile idiopathic arthritis (JIA) still remains relevant. Till present, pediatric rheumatologists have not reached a consensus on this issue yet.The aim of this study was to search for predictors of early failure of local steroid therapy and assessment of its feasibility in patients with oligoarticular JIA.Materials and methods. In a retrospective study, 92 children aged 11 months – 9 years with chronic oligoarticular JIA without extra-articular manifestations were monitored. The features of the clinical, instrumental and laboratory diagnosis during the disease onset were studied, along with the dynamics of the articular syndrome and the effectiveness of intra-articular administration of corticosteroid drugs.Results and discussion. The data on 92 children with 164 active joints who received 218 local intra-articular injections of triamcinolone acetonide at the onset of the disease were analyzed. Intra-articular injections of triamcinolone acetonide at a dose of 20–40 mg were performed with an interval of 3, 6, and 12 months, depending on the intensity of the disease. In about one third of children with oligoarticular JIA, arthritis became inactive on average after two intra-articular injections of triamcinolone acetonide. The study did not reveal the predictors of early ineffective topical corticosteroid monotherapy in children. No clinical, instrumental, and laboratory signs were identified that would directly indicate the need for early therapy with methotrexate.Conclusion. Triamcinolone acetonide is an effective and safe drug for children with oligoarticular JIA. Despite the widespread use of biological, gene, and other innovative therapies, application of local corticosteroids as the firstline therapy in children with oligoarticular JIA should not be neglected. |
topic |
oligoarticular juvenile idiopathic arthritis local steroid therapy triamcinolone acetonide |
url |
https://bulletin.tomsk.ru/jour/article/view/4377 |
work_keys_str_mv |
AT ankozhevnikov retrospectiveanalysisoftheeffectivenessoflocalcorticosteroidtherapyinchildrenwitholigoarticularjuvenileidiopathicarthritis AT napozdeeva retrospectiveanalysisoftheeffectivenessoflocalcorticosteroidtherapyinchildrenwitholigoarticularjuvenileidiopathicarthritis AT msnikitin retrospectiveanalysisoftheeffectivenessoflocalcorticosteroidtherapyinchildrenwitholigoarticularjuvenileidiopathicarthritis AT onmaricheva retrospectiveanalysisoftheeffectivenessoflocalcorticosteroidtherapyinchildrenwitholigoarticularjuvenileidiopathicarthritis AT tvmurashko retrospectiveanalysisoftheeffectivenessoflocalcorticosteroidtherapyinchildrenwitholigoarticularjuvenileidiopathicarthritis AT nyuorlova retrospectiveanalysisoftheeffectivenessoflocalcorticosteroidtherapyinchildrenwitholigoarticularjuvenileidiopathicarthritis AT slbogdanova retrospectiveanalysisoftheeffectivenessoflocalcorticosteroidtherapyinchildrenwitholigoarticularjuvenileidiopathicarthritis AT ganovik retrospectiveanalysisoftheeffectivenessoflocalcorticosteroidtherapyinchildrenwitholigoarticularjuvenileidiopathicarthritis |
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