The systemic effect of intraarticular administration of corticosteroid on markers of bone formation and bone resorption in patients with rheumatoid arthritis.
OBJECTIVE
To assess the effects of intraarticular (IA) corticosteroid use on bone metabolism in patients with rheumatoid arthritis (RA).


METHODS
Levels of the bone turnover markers, serum osteocalcin (BGP) and urinary pyridinoline (PYD), were monitored in RA patients for 4 weeks following a single IA administration of xylocaine alone or in combination with triamcinolone acetonide.


RESULTS
Levels of the bone resorption marker, PYD, did not show any significant change, whereas BGP levels were drastically decreased 1 day after IA administration of corticosteroid, and then returned to pretreatment levels by day 14. The efficacy of IA corticosteroid treatment lasted for 4 weeks.


CONCLUSIONS
Our results suggest that IA administration of corticosteroid has no net effects on bone resorption and only a transient systemic effect on bone formation. IA corticosteroid administration may be better for bone metabolism than continuous use of orally administered corticosteroid.
Emkey
R D
RD
Bone Research Center, Reading Hospital and Medical Center, West Reading, PA 19612, USA.
Lindsay
R
R
Lyssy
J
J
Weisberg
J S
JS
Dempster
D W
DW
Shen
V
V
D000368:Aged; D000596:Amino Acids / Q000652:urine; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology*; D015415:Biomarkers; D001862:Bone Resorption; D001842:Bone and Bones / Q000378:metabolism*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010012:Osteogenesis / Q000187:drug effects*; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*
D000596:Amino Acids; D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D004338:Drug Combinations; D015675:Osteocalcin; C015484:pyridinoline; D008012:Lidocaine; D014222:Triamcinolone Acetonide