Prolonged Effect from Intramuscular Corticosteroids: Triamcinolone Acetonide in Rheumatoid Arthritis

In a continuing evaluation of the intramuscular administration of steroids in the treatment of rheumatic disease, 444 injections, each of 100 mg., of TACTN have been administered to 77 patients. The desired anti-inflammatory effect was obtained in approximately 75 per cent of patients. A 50-mg. dose of TACTN was less satisfactory than an 80-mg. dose. An 80-mg. dose was less satisfactory than a 100-mg. dose and a 100-mg. dose was less satisfactory than a 140-mg. dose in most of a limited number of patients in which these doses were compared. Side effects ordinarily encountered with oral steroids were seen with TACTN. Moon facies and ecchymoses were the most common, being evident in approximately half of the treated patients, while hirsutism, muscle cramps and diuresis were noted each in 10 per cent of patients. Acne was noted in only a few patients, and other effects in only 1 or 2 patients. Gastrointestinal complications were minimal, proving a definite advantage over orally administered steroids. The intramuscular administration of TACTN provides satisfactory antirheumatic effect in a high percentage of patients. The sustained effect of injections permits long intervals between injections, thereby reducing the risk of unwanted side effects in certain individuals.