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Triamcinolone Diacetate
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
General aspects of corticosteroids used on the skin and mucous membranes are discussed in Chapter 2.4. A practical guideline for diagnosing allergic reactions to corticosteroids is presented in ref. 1. See also triamcinolone (Chapter 3.352), triamcinolone acetonide (Chapter 3.353), and triamcinolone hexacetonide (Chapter 3.355).
The Child With A Limp
Published in Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan, Diagnosing and Treating Common Problems in Paediatrics, 2017
Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan
JIA will require treatment with NSAIDs as part of the initial strategy pending rheumatology consultation (seeEvidence 5). If only one joint is affected, intra-articular steroid injections (triamcinolone hexacetonide) are used. When methotrexate is used there is a lag of up to 3 months before a therapeutic effect is evident.
Alopecia areata: Pathogenesis, clinical features, diagnosis, and management
Published in Jerry Shapiro, Nina Otberg, Hair Loss and Restoration, 2015
Intralesional corticosteroid injection is first line therapy for adult patients with less than 50% scalp involvement [179]. For circumscribed AA, intradermal corticosteroids remain the therapeutic standard [180]. Porter and Burton [181] demonstrated response rates of 64% using triamcinolone acetonide and 97% using the less soluble and more atrophogenic triamcinolone hexacetonide. Price [179], Shapiro [182], Mitchell and Krull [169,183], Whiting [183], Bergfeld [184], and Thiers [185] prefer triamcinolone acetonide. Concentrations of triamcinolone acetonide vary from 2.5 to 10.0 mg/mL diluted either in xylocaine or sterile saline. Price [179] prefers 10 mg/mL, Whiting [183] prefers 5–10 mg/mL, Shapiro [182] prefers 5 mg/mL, Bergfeld prefers 2.5–5.0 mg/mL [184], and Thiers [185] prefers 3.3 mg/mL.
Reduction of systemic exposure and side effects by intra-articular injection of anti-inflammatory agents for osteoarthritis: what is the safer strategy?
Published in Journal of Drug Targeting, 2023
Zuoxu Xie, Lu Wang, Jie Chen, Zicong Zheng, Songpol Srinual, Annie Guo, Rongjin Sun, Ming Hu
One of the most studied NSAIDs is tenoxicam. An early study showed that better improvement in visual analog scale (VAS) was observed in the tenoxicam group over the control group [29]. Unlu et al. [30] and Erbas et al. [31] both reported that the efficacy of tenoxicam through IA injection showed no significant difference when compared to oral administration of tenoxicam. A recent clinical study combined tenoxicam with triamcinolone hexacetonide via IA. In this study, the efficacy of the combination appeared to be superior to the monotherapies with the individual drugs; the pronounced improvement in VAS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was observed in the combination group from the first month after injection and lasted for 6 months until the end of the study [32].
Intralesional betamethasone versus triamcinolone acetonide in the treatment of localized alopecia areata: a within-patient randomized controlled trial
Published in Journal of Dermatological Treatment, 2022
Vando Barbosa de Sousa, Francisco Placido Arcanjo, Fernando Aguiar, Jaqueline Vasconcelos, Antonio Flavio Oliveira, Aline Honório, Juliana Pontes
Alopecia areata (AA) is a relatively common disease that affects hair follicles, with a cumulative lifetime incidence of around 2%. Typically, it is manifested with the sudden appearance of well-defined, circular areas of alopecia, without inflammatory signs on the scalp (1). Its pathogenesis is not yet fully understood, but strong evidence makes us believe it is an autoimmune disorder (2). Numerous forms of treatment have been studied. In its most typical, patchy and localized presentation, the use of intralesional corticosteroids is the first-line of therapy. The literature is unanimous in indicating intralesional triamcinolone acetonide (ITA) as the therapy of choice (2). Although this treatment modality has been used for over 60 years, the use of other corticosteroids such as betamethasone is poorly studied. In some countries, such as Brazil, triamcinolone acetonide is not commercially available, its less soluble derivative triamcinolone hexacetonide or betamethasone is then used (3). For having an excessively long half-life, triamcinolone hexacetonide is less suitable for intralesional use (4). Although intralesional betamethasone (IB) is often used in cases due to unavailability of ITA, to date, there is insufficient evidence in the literature to indicate the best concentration for use in AA, nor its efficacy. This study aims to evaluate the effectiveness and safety of using IB when compared to ITA.
Peptidylarginine deiminase 4 (PAD4) activity in early rheumatoid arthritis
Published in Scandinavian Journal of Rheumatology, 2020
MK Jonsson, T Kantyka, K Falkowski, A Aliko, AB Aga, S Lillegraven, J Sexton, BT Fevang, P Mydel, EA Haavardsholm
The analyses were performed in patients participating in Aiming for remission in rheumatoid arthritis: a randomized trial examining the benefit of ultrasonography in a clinical tight control regimen - the ARCTIC trial (ClinicalTrials.gov registration: NCT01205854) (23), in which DMARD naïve patients with early RA classified according to the 2010 ACR/EULAR criteria were recruited between September 2010 and April 2013. All patients were treated according to a tight control treat-to-target strategy in which all patients were evaluated at baseline and 12 additional study visits during the 2 year follow-up. The treatment target was no swollen joints and a Disease Activity Score (DAS) < 1.6 (24), and in half the patients additionally no joints with ultrasound power Doppler activity (23). Core clinical measures were collected at each visit. Initial treatment consisted of metho-trexate monotherapy 15 mg/week escalating to 20 mg/week and prednisolone starting at 15 mg with tapering to withdrawal over 7 weeks. If the treatment target was not reached, treatment was intensified with escalation to subcutaneous methotrexate 25–30 mg/week following a predetermined treatment protocol, followed by triple therapy and then biological DMARDs (23). Swollen joints and/or joints with power Doppler activity could be injected with triamcinolone hexacetonide (up to a maximum of 80 mg per visit). As clinical and radiographic outcomes of the two strategy arms were similar after 2 years (23), the data from the two arms were pooled and analysed together in this report.