Intra-articular injection in patients with juvenile idiopathic arthritis: factors associated with a good response

Intra-articular injection in patients with juvenile idiopathic arthritis: factors associated with a good response

Alternative title Infiltração intra-articular em pacientes com artrite idiopática juvenil: fatores associados à boa resposta
Author Cunha, Ana Luiza Garcia Autor UNIFESP Google Scholar
Silva, Vanessa Bugni Miotto e Autor UNIFESP Google Scholar
Osaku, Fabiane Mitie Autor UNIFESP Google Scholar
Niemxeski, Luisa Brasil Autor UNIFESP Google Scholar
Furtado, Rita Nely Vilar Autor UNIFESP Google Scholar
Natour, Jamil Autor UNIFESP Google Scholar
Sande, Maria Teresa de Autor UNIFESP Google Scholar
Terreri, Maria Teresa Ramos Ascensão Autor UNIFESP Google Scholar
Abstract Introduction: Intra-articular injection of corticosteroids (IIC) for treatment of patients with juvenile idiopathic arthritis (JIA) is increasingly used in Pediatric Rheumatology. Objectives: To describe the clinical course of patients undergoing IIC in our Pediatric Rheumatology Unit. Methods: Retrospective study of patients with JIA undergoing IIC from January 2008 to December 2012, with a minimum follow-up of six months after the injection. Good response to IIC was set as the presence of inactivity on the infiltrated joint by at least six months. Results: Eighty-eight patients underwent a total of 165 IICs. Of these, 75% were girls and 35.2% had persistent oligoarticular JIA. The mean age at diagnosis was 6.8 years, and when IIC was carried out, 12.2 years. Regarding patients, younger age at diagnosis (p = 0.037) and the occurrence of uveitis in the course of the disease (p = 0.015) were associated with good response to IIC. From 165 IICs, 63% had a good response and joints remained inactive for a median of 18.1 months. The type of joint injection (p =0.001), lesser values stated in the overall visual analog scale by the physician (p = 0.015) and by parents/patient (p = 0.01) have been associated with a good response to IIC. Nine adverse events (5.4%) were observed. Conclusion: In our study, more than half of the joints showed a good response to IIC. Younger patients at diagnosis and uveitis during the course of the disease had good response to IIC. Knees, wrists and elbows were the joints that best responded to IIC. IIC proved to be a safe procedure. (C) 2016 Elsevier Editora Ltda.

Introdução: A infiltração intra-articular de corticosteroides (IIC) para tratamento de pacientes com artrite idiopática juvenil (AIJ) é cada vez mais usada em reumatologia pediátrica. Objetivos: Descrever a evolução clínica dos pacientes submetidos à IIC em nosso setor de reumatologia pediátrica. Métodos: Estudo retrospectivo de pacientes com AIJ submetidos à IIC de janeiro/2008 a dezembro/2012, com seguimento mínimo de seis meses após a infiltração. Boa resposta à IIC foi definida como inatividade na articulação infiltrada por, no mínimo, seis meses. Resultados: Foram submetidos a 88 pacientes a 165 IICs. Desses, 75% eram meninas e 35,2% apresentavam AIJ oligoarticular persistente. A média de idade ao diagnóstico foi de 6,8 anos e à IIC de 12,2 anos. Em relação aos pacientes, a menor idade ao diagnóstico (p = 0,037) e a ocorrência de uveíte no curso da doença (p = 0,015) foram associados à boa resposta à IIC. Das 165 IICs, 63% apresentaram boa resposta e as articulações permaneceram inativas por um tempo médio de 18,1 meses. O tipo de articulação infiltrada (p = 0,001), menores valores na escala visual analógica global do médico (p = 0,015) e dos pais/paciente (p = 0,01) foram associados a uma boa resposta à IIC. Nove efeitos adversos (5,4%) foram observados. Conclusão: Em nosso estudo, mais da metade das articulações mostrou boa resposta à IIC. Os pacientes com menor idade ao diagnóstico e uveíte durante o curso da doença tiveram boa resposta à IIC. Os joelhos, punhos e cotovelos foram as articulações que mais bem responderam à IIC. A IIC mostrou ser um procedimento seguro.
Keywords Intra-articular injection
Juvenile idiopathic arthritis
Triamcinolone hexacetonide
Treatment and uveitisa
Infiltração intra-articular
Artrite idiopática juvenil
Hexacetonido de triancinolona
Tratamento e uveíte
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Date 2016
Published in Revista Brasileira De Reumatologia. New York, v. 56, n. 6, p. 490-496, 2016.
ISSN 0482-5004 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Inc
Extent 490-496
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000389548800005
SciELO ID S0482-50042016000600490 (statistics in SciELO)

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