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LITERATURE

Triamcinolone Acetonide Extended‑Release: A Review in Osteoarthritis Pain of the Knee


Triamcinolone acetonide extended-release (ER) 32 mg (Zilretta®) is approved in the USA for the management of osteoarthritis
(OA) pain of the knee and is administered as a single, 5 mL intra-articular (IA) injection. Although the therapeutic effects
from IA corticosteroids are typically short-lived, triamcinolone acetonide ER is formulated in poly (lactic-co-glycolic acid)
(PLGA) microspheres that slowly release triamcinolone acetonide in the synovium, enabling their prolonged presence in the
joint. This reduces systemic exposure and lessens corticosteroid-related systemic adverse reactions, such as blood glucose
elevations. In a 24-week, randomized, phase III clinical trial, triamcinolone acetonide ER 32 mg significantly improved mean
average daily pain intensity in patients with knee OA relative to placebo, and pain, stiffness and physical function (according
to WOMAC criteria) relative to placebo and triamcinolone acetonide crystalline suspension (CS). Triamcinolone acetonide
ER was generally well tolerated, with a tolerability profile similar to that of triamcinolone acetonide CS and placebo.
Findings from a single-arm phase IIIb study indicated that a repeat administration of triamcinolone acetonide ER may be
similarly efficacious to an initial injection without having deleterious effects on cartilage or other aspects of joint structure.
Thus, triamcinolone acetonide ER expands the treatment options available for the management of OA pain of the knee


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Drugs (2019) 79:455–462
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