ABSTRACT

Profile of Intra-articular Corticosteroid Injections (IACIs) and Its Relationship to Patient

Outcome in Juvenile Idiopathic Arthritis (JIA) in Dr. Sardjito Hospital

Tika Vandasari, Cahya Dewi Satria, Sumadiono

Child Health Department, Dr. Sardjito Hospital, Medical School, Gadjah Mada University

BACKGROUND: Juvenile Idiopathic Arthritis (JIA) is one of the more common chronic disease of
childhood, with a prevalence of approximately 1 per 1,000 . The goals of treatment for JIA are
suppression of inflammation, achievement of remission, relief of pain, and maintenance of
function and doing so with minimal toxicity. The choice of therapy is guided by severity of disease
activity and features indicating poor prognosis. Intra-articular corticosteroid injections (IACIs) are
considered to be effective for short-term relief of synovitis.

OBJECTIVE: To describe JIA cases with intra-articular corticosteroid and outcomes of treatment.

METHODE: A retrospective cohort of 24 patients of JIA who admitted to Dr. Sardjito Hospital
between September 2014 until January 2016 were evaluated for the outcome. Profile of IACIs
and other treatments were calculated. The other factors predicted to be involved in patients
outcome like sex, age, JIA category, Rheumatoid Factor (RF) were also measured. Patients
outcome were stratified as remission and not remission. The relationship between IACIs and
patient outcome in JIA was analyzed by Kolmogorov Smirnov Test.

RESULTS: Percentage of therapy in JIA patients such as Non Steroidal Anti Inflammatory Drugs
(NSAIDs), Corticosteroid, Metotrexate and IACIs were 79,2%, 45,8%, 54,2%, and 41,7%
respectively. There were 10 patients who received IACIs, 7 of which were diagnosed with
oligoarthritis and the rest were diagnosed with polyarthritis. Most of the patients were girl
(58,3%), more than 8 years old (75%), oligoarthritis type (58,3%), and negative Rheumatoid
Factor (58,3%). Of these 24 patients, 9 (37,5%) patients had remission . Based on comparative
test, there was no relationship between administration of Intra-articular Corticosteroid Injections
(IACIs) with patient outcome in Juvenile Idiopathic Arthritis significantly (OR= 1,2 ; p = 1,00).

CONCLUSION: There was no relationship between IACIs and patient outcome in Juvenile
Idiopathic Arthritis significantly, but the odds ratio score showed that IACIs was likely to provide
better outcomes. There were any factors predicted to be involved in patients outcome like
therapy combination, sex, age, JIA category, Rheumatoid Factor (RF) and those can be more
analyzed.

KEYWORDS: Juvenile idiopathic arthritis, Intra-articular injection, Steroid injection, Outcome.