Kenalog
Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion.

Jonas JB, Kreissig I, Degenring RF.

Department of Ophthalmology and Eye Hospital, Faculty for Clinical Medicine, Mannheim, Ruprecht-Karls-University Heidelberg, Germany. jost.jonas augen.ma.uni-heidelberg.de

PURPOSE: To report the clinical outcome of a patient receiving an intravitreal injection of triamcinolone acetonide as treatment of bilateral, long-standing, cystoid macular edema due to central retinal vein occlusion. METHODS: A 70-years-old patient suffering from bilateral central retinal vein occlusion for 2 years and 1.5 years, respectively, received transconjunctivally an intravitreal injection of 25 mg of crystalline triamcinolone acetonide in each eye, with 10 weeks between injections. RESULTS: During the follow-up period of 4 months (OD) and 6 weeks (OS), respectively, visual acuity increased from 0.05 to 0.25 in his right eye and from 0.125 to 0.25 in his left eye. Fluorescein angiography showed a decrease of fluorescein leakage in the macular area. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide may be a therapeutic option for long-standing cystoid macular edema due to central retinal vein occlusion.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12271378&dopt=Abstract triamcinolone Kenalog



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Capsule injection for the prevention of contracture.

Caffee HH.

Division of Plastic Surgery, University of Florida College of Medicine, Gainsville, FL 32601, USA. caffeehh mail.surgery.ufl.edu

From 1990 through 1999, 164 patients with prior augmentation mammaplasty underwent implant removal by the author, and 128 of the patients had the implants replaced. Of that group, 86 were noted on preoperative examination to have capsule contracture of grade III or IV. Patients with preoperative capsule contracture were offered the option of a postoperative injection of triamcinolone intended to prevent recurrent contracture. Patients who elected to have replacement with gel-filled implants were excluded. A total of 48 patients underwent injection of triamcinolone 4 to 6 weeks after surgery. Of the remaining 38 patients, 12 were not offered injection because they selected gel-filled implants and 26 declined injection. Follow-up ranged from 8 months to 10 years (mean, 46 months), and no patient was followed up for less than 8 months. Of the 48 patients who received injections, two developed recurrent contracture, one at 3 years and one at 4.5 years. Of the 26 patients who declined injection, eight had recurrent contracture (three bilateral) within 12 months. These data suggest that in this high-risk group of patients, a postoperative injection of triamcinolone can reduce the risk of recurrent contracture.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12360077&dopt=Abstract triamcinolone Kenalog



Kenalog
Asthma treatment costs using inhaled corticosteroids.

Holzer SS, Engelhart L, Crown WH, L'Herrou TA, Kennedy ST.

American Academy of Otolaryngology-Head and Neck Surgery Foundation, Washington DC, USA.

Asthma is a chronic inflammatory disorder of the airways that affects 10 to 17.5 million people and leads to more than $5 billion in treatment costs in the Unites States annually. This retrospective study is an initial step in understanding the beneficial economic outcomes of inhaled corticosteroid therapy by determining whether differences exist in healthcare utilization expenditures for three inhaled corticosteroids available for use in the United States: (1) beclomethasone dipropionate (Vanceril/Schering and Beclovent/Allan & Hanburys); (2) flunisolide (Aerobid/Forest); and (3) and triamcinolone acetonide (Azmacort/Rhone-Poulenc Rorer). This study was based on an analysis of 4,441 patients with at least one pharmaceutical claim for one of the study drugs, using inpatient, outpatient, and prescription drug claims data obtained from The MEDSTAT Group's MarketScan database for calendar years 1990 through 1993. We tested a null hypothesis for no differences in total asthma treatment costs, when drugs were excluded, using multivariate linear regression modeling controlling for patient demographic and clinical characteristics that might affect the study outcome. We found that, after excluding study drug payments and controlling for other contributing factors, total asthma healthcare expenditures to triamcinolone acetonide (Azmacort) users were higher than those for beclomethasone dipropionate (Vanceril and Beclovent) and flunisolide (Aerobid) users. When study drug costs were included in the expenditure measure, both triamcinolone acetonide (Azmacort) and flunisolide (Aerobid) users had higher expenditures than did beclomethasone dipropionate (Vanceril and Beclovent) users. No significant differences in expenditures were detected between Vanceril and Beclovent patients, a finding consistent with the fact that these drugs are the same type of inhaled corticosteroid. Other factors contributing to differences in total asthma healthcare costs included patient age, patterns of switching among and continuing with study drugs, prestudy asthma utilization or drug proxy severity, and comorbidities of precipitating illnesses.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10170293&dopt=Abstract triamcinolone Kenalog



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Somatostatin-induced modulation of inflammation in experimental arthritis.

Matucci-Cerinic M, Borrelli F, Generini S, Cantelmo A, Marcucci I, Martelli F, Romagnoli P, Bacci S, Conz A, Marinelli P, et al.

University of Cagliari, Italy.

OBJECTIVE. To study the antiinflammatory effect of different doses of intraarticular somatostatin in experimental arthritis in rabbits. METHODS. Chronic arthritis was induced by a single injection of fibrin into the knee joint of rabbits previously sensitized to this antigen. The effects of sequential intraarticular injections of somatostatin into the rabbit knee, at doses of 500, 750, and 1,000 micrograms, were monitored by measuring knee joint circumferences and hematologic parameters. The measurements were compared with those obtained following use of triamcinolone acetonide and placebo. At the end of the experiments, the knee joints were examined histologically. RESULTS. Somatostatin treatment induced a statistically significant and dose-related reduction of knee joint swelling. This effect was shorter than that produced by triamcinolone acetonide; however, the antiinflammatory activity elicited by successive doses of triamcinolone acetonide declined both in extent and duration, while the effects of somatostatin remained unchanged at each successive treatment. Histopathologic observations showed that both somatostatin and triamcinolone acetonide reduced the inflammatory signs in the joint structures, although triamcinolone acetonide appeared to be more effective. CONCLUSION. These findings suggest that somatostatin exerts an antiinflammatory effect in this model of experimental arthritis and may represent a valid and safer alternative to corticosteroids for intraarticular therapy of arthritis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7488291&dopt=Abstract triamcinolone Kenalog



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Referred ocular pain relieved by suboccipital injection.

Ellis BD, Kosmorsky GS.

Division of Ophthalmology, Cleveland Clinic Foundation, OH 44195, USA.

Pain originating from ophthalmic disease has been well documented. A series of patients presenting with eye or periorbital pain attributed to cervical region dysfunction were diagnosed and treated with injections of subcutaneous lidocaine followed by triamcinolone acetonide. Twelve patients, 11 women and 1 man, ranging in age from 20 to 82 years had an evaluation including a complete eye examination, and laboratory tests and neuroimaging as dictated by the history to exclude structural abnormalities or systemic disease. All patients had marked focal suboccipital tenderness ipsilateral to the side of their headache and eye pain. A subcutaneous injection with 2% lidocaine followed by triamcinolone acetonide 40 mg was administered directly to the site of focal tenderness. After injection, five patients described total relief of pain, five patients described some degree of pain relief, and two patients had no relief of headache. Duration of pain relief ranged from several hours to 3 months. Patients may present with periorbital or eye pain as a result of disease affecting the cervical sensory roots with subsequent stimulation of the trigeminal apparatus. Subcutaneous injection of lidocaine and triamcinolone acetonide may be of help in the diagnosis of these patients and provide temporary relief.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7537725&dopt=Abstract triamcinolone Kenalog



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Determination of triamcinolone acetonide in equine serum and urine by liquid chromatography-atmospheric pressure ionization mass spectrometry.

Koupai-Abyazani MR, Yu N, Esaw B, Laviolette B.

Can Test Laboratories Ltd., Vancouver, BC, Canada.

Urine and serum samples collected from four standard-bred mares after 30-mg intraarticular administrations of triamcinolone acetonide were analyzed using combined high-performance liquid chromatography-atmospheric pressure ionization mass spectrometry. Maximum triamcinolone acetonide concentrations of 32.3, 14.8, 24.3, and 29.4 ng/mL in the urine and 2.7, 1.9, 2.3, and 2.5 ng/mL in the serum samples were observed. The peak concentrations of the drug were detected approximately 22 h (urine) and 12 h (serum) after administration. The drug elimination profiles for both urine and serum are presented and discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7564297&dopt=Abstract triamcinolone Kenalog