Richard Iorio, MD; Paul Lachiewicz, MD; Peter L. Salgo, MD; and Andrew Spitzer, MD, debate clinical studies with triamcinolone acetonide injectable suspension and the use of platelet-rich plasma injections and other therapies to treat osteoarthritis of the knee.
Now there was this macallan dan study is that what you’re recording before or is there new data there are there are several studies related to this product and is probably better than us but i think this study refers to maintenance of articular cartilage and patients who receive this drug i think we’d all be a little skeptical about this but that’s what they found you
Know i think that the mcalinden study he’s a fantastic researcher the study that we’re talking about is repeated every three months injection of standard triamcinolone to see tonight it is not related and not a part of the extended release this is standard crystalline kenalog basically and this showed a decrease in cartilage volume and-and-and-and slight worsening
Of the osteoarthritis and this was a study that was done where these repeated doses were given at least as far as i can tell from the study having read at a number of times where the repeated doses were given without necessarily reassessing symptoms at those different points in time and the assessment of the efficacy relative to saline was done only at three month
Intervals when you would expect already for the standard immediate release steroid to have waned in terms of its clinical effect so there were some problems with the study but nevertheless it raises a little bit of a red flag about what repeated exposure at very high levels of steroid with these pulses every three months might do over the long haul and that was the
The pulsed regular ngon not only capsule it was the long-acting drug with the regular i think the other thing is is that they’re they’re there while there was synovitis and some evidence of osteoarthritis these are not the patients that we typically see in our practices who are pretty much far along the spectrum of the cartilage being already quite diseased another
Interpretation of the same data could be well these people got more active because they were less than thematic therefore leading to more decorative issues rapido just to be complete can we also just discuss among ourselves these clinics that are spouting up injecting growth factors into knees and platelet-rich plasma and who knows a lot be my guest i’m backing off
On this so you know i think both our academy and the scientific literature i’ve looked at has not shown very good results with this or that it’s a value what do you think rich so there have been some less than stellar studies that have shown minor improvements and people there’s a huge placebo effect with these injections if you pay $5,000 for an injection you’re
Likely to say well it’s very very expensive i was i need and they’re not usually covered by insurance what i tell patients who come in and ask about this is that i’d say that there’s one person who definitely has an improvement in their overall quality of life as a result of the injection and that’s the injector who’s good at $10,000 but the bottom line is is that
I think there is a reasonable attempt to explore new avenues with mesenchymal stem cells with platelet-rich plasma but as a recent article suggests in our literature that jbg has two reviews is that there’s such heterogeneity of these studies that things have not been standardized it’s really not yet ready for primetime
Transcribed from video
Clinical Studies With Triamcinolone Acetonide Suspension By HCPLive