1890: The Efficacy of Intra-articular Triamcinolone Acetonide 10 mg vs. 40 mg in Patients with Knee Osteoarthritis: a Non-inferiority, Randomized, Controlled, Double-blind, Multicenter Study

Sumapa Chaiamnuay¹, Komchan Utamawatin², Ong-art Phruetthiphat² and Rit Apinyankul³, ¹Phramongkutklao hospital, Nonthaburi, Thailand, ²Phramongkutklao Hospital, Bangkok, Thailand, ³Konkaen University Hospital, Konkaen, Thailand

Background/Purpose: Intra-articular (IA) corticosteroid injection is recommended in refractory knee osteoarthritis patients. However, 40-mg of triamcinolone IA every 3 months for 2 years reduces cartilage volume as compared to saline IA. The objective of this study is to determine the non-inferiority of 10-mg versus 40-mg of triamcinolone acetonide (TA) for treatment of pain in symptomatic knee osteoarthritis at week 12.

Methods: This was a double-blind, randomized, controlled trial conducted in 84 symptomatic knee osteoarthritis patients. The 10-mg or 40-mg of TA were 1:1 randomized and injected to the affected knees. The primary outcome was the 12-week difference from baseline in pain visual analog scale (pVAS: 0-10) with a pre-specified lower margin for non-inferiority of 1cm. Modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol Group 5 Dimensions (EQ5D), Knee Injuries and Osteoarthritis Outcome Score (KOOS) questionnaire, chair standing test, 20-m walking time, and adverse events were recorded at baseline, at week 4, and week 12.

Results: The mean differences of pain VAS (95% confidence interval: CI) between the two groups at baseline and week 12 were 0.8 (-0.8, 2.4) with p of 0.002 for non-inferiority. There were no differences in pain reduction and quality of life improvement between 10-mg and 40-mg groups. The mean differences (95%CI) of WOMAC, KOOS pain, EQ5D and KOOS quality of life between baseline and week 12 were 0.4 (-1.1, 1.9). -8.7 (-21.3, 3.9), 1.3(-7.1, 9.6) and 1.8 (-11.5, 15.0), respectively.

There were significant improvements in pain and quality of life between baseline and week 12 in both groups.

Conclusion: The 10 mg of TA is non inferior to 40 mg TA in improving pain in patients with symptomatic knee OA. Both 10 mg and 40 mg of TA significantly improved pain and quality of life in patients with symptomatic knee OA.

Flowchart of patients with symptomatic knee osteoarthritis through the study

Figure 2: Non-inferiority of intraarticular Triamcinolone 10 mg versus Triamcinolone 40 mg for the treatment of symptomatic knee osteoarthritis
Disclosures: S. Chaiamnuay, None; K. Utamawatin, None; O. Phruetthiphat, None; R. Apinyankul, None.