Aleksei Kozhevnikov
Introduction: Intra-articular steroid injections are the first-line antirheumatic drugs of oligoarticular onset juvenile arthritis (oligo-JA). Despite significant advances in treatment (anti-TNF, block IL6) the choice of DMARDs for the pediatric chronic joint disease remains relevant. This study aimed to search for candidate biomarkers influencing efficacy treatment by early intra-articular steroid injections in children with oligo-JA.
Patients and Methods: Efficacy of early isolated intra-articular injections of triamcinolone acetonide was analyzed in 120 children with oligoarticular onset Juvenile Arthritis (JA).
Results and Discussion: 42 children (all girls; 35%) were achieved remission JA after one or two isolated intra-articular injections (is- IAI) of Triamcinolone Acetonide (TA). 78 children (54% girls; 11% boys) didn’t achieve inactive JA after two and more is-IAI of TA. There were no determined relationships between clinical, laboratory signs and efficacy is-IAI of TA in children with oligo-JA. The analysis revealed a correlation between a short phase of beneficial effect after is-IAI of TA and risk of activity disease (with an inactive phase of arthritis less than 3 months, the risk activity was OR=2.09, p<0.001; with an inactive phase less than 2 months OR=8.9, p <0.001).
Conclusion: TA is an efficacy treatment in children with oligoarticular JA. There are no biomarkers for the prediction of poor treatment response in oligo-JA to early steroid injections. But a short phase of beneficial effect after is-IAI of TA may be a sign of risk activity disease.
KeywordsOligoarticular juvenile arthritis • Local steroid therapy • Triamcinolone acetonide