Extended-release triamcinolone acetonide viable for osteoarthritis patients with type 2 diabetes
medwireNews: Triamcinolone acetonide extended-release (TA-ER) may be a good option for the treatment of knee osteoarthritis in patients with comorbid type 2 diabetes, suggest phase II study findings.
The results showed that glucose levels were more stable with intra-articular TA-ER than with standard triamcinolone acetonide crystalline suspension (TAcs), and there was “minimal glycaemic control disruption following [TA-ER] injection,” notes the team.
Among 18 of 33 patients with knee osteoarthritis and type 2 diabetes randomly assigned to receive a single intra-articular injection of TA-ER 32 mg, the mean change in average daily glucose (measured by continuous glucose monitoring) from baseline to 1–3 days after treatment was 14.7 mg/dL, compared with 33.9 mg/dL in the 15 patients randomly assigned to receive a single TAcs dose of 40 mg. This gave a significant least squares mean difference of 19.2 mg/dL.
Steven Russell (Massachusetts General Hospital, Boston, USA) and colleagues also found that during the first 3 days after injection, hourly glucose levels were in the target glycemic range of 70–180 mg/dL 63.3% of the time among patients given TA-ER, compared with 49.7% among those given TAcs. And the respective rates for which hourly glucose levels were above this target range were 34.5% versus 49.9%.
The researchers note that in post-hoc analyses, the within-group increase in glucose levels was statistically significant in patients receiving TAcs, whereas it was not for those treated with TA-ER, “suggesting that TA-ER did not significantly disrupt the glycaemic control of participants with type 2 diabetes mellitus.”
There was no significant difference between the two groups in the rate of adverse events, all of which were grade 1 or 2 in severity, at 11.1% among TA-ER-treated patients and 13.3% among those given TAcs.
The researchers conclude in Rheumatology: “These findings support previously identified disruption of glycaemic control with TAcs in diabetic patients; this is the first study to show negligible effects on [glucose levels] after an [intra-articular] corticosteroid (TA-ER) injection.
“The results are consistent with the relatively low systemic exposure to TA afforded by the extended-release formulation TA-ER, and suggest that TA-ER may be administered with minimal disruption of glycaemic control in people with knee osteoarthritis and type 2 diabetes mellitus.”
By Lucy Piper
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