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Equine veterinary journal2020; 53(6); 1277-1286; doi: 10.1111/evj.13396

Treatment effects of intra-articular triamcinolone acetonide in an equine model of recurrent joint inflammation.

Abstract: Intra-articular triamcinolone acetonide is a widely used treatment for joint inflammation despite limited scientific evidence of its efficacy. Objective: To investigate if intra-articular triamcinolone acetonide has sustained anti-inflammatory effects using an equine model of repeated joint inflammation. Methods: Randomised controlled experimental study. Methods: For three consecutive cycles 2 weeks apart, inflammation was induced in both middle carpal joints of eight horses by injecting 0.25 ng lipopolysaccharide (LPS). After the first LPS injection only, treatment with 12 mg triamcinolone acetonide (TA) followed in one randomly assigned joint, while the contralateral joint was treated with sterile saline (control). Clinical parameters (composite welfare scores, joint effusion, joint circumference) were recorded and synovial fluid samples were analysed for various biomarkers (total protein, WBCC; PGE ; CCL2; TNFα; MMP; GAGs; C2C; CPII) at fixed timepoints (post injection hours 0, 8, 24, 72 and 168). The effects of time and treatment on clinical and synovial fluid parameters and the presence of time-treatment interactions were tested using a linear mixed model for repeated measures with horse as a random effect, and time and treatment as fixed effects. Results: The TA treated joints showed significantly higher peak synovial GAG concentrations (Difference in means 283.1875 µg/mL, 95% CI 179.8, 386.6, P < 0.000), and PGE levels (Difference in means 77.8025 pg/mL, 95% CI 21.2, 134.4, P < 0.007) after the first inflammation induction. Significantly lower TP levels were seen with TA treatment after the second induction (Difference in means -7.5 g/L, 95% CI -14.8, -0.20, P < 0.04) . Significantly lower WBCC levels were noted with TA treatment after the first (Difference in means -23.7125 × 10  cells/L, 95% CI -46.7, -0.7, P < 0.04) and second (Difference in means -35.95 × 10  cells/L, 95% CI -59.0, -12.9, P < 0.002) inflammation inductions. Significantly lower general MMP activity was also seen with TA treatment after the second inflammation inductions (Difference in means -51.65 RFU/s, 95% CI -92.4, -10.9, P < 0.01). Conclusions: This experimental study cannot fully reflect natural joint disease. Conclusions: In this model, intra-articular TA seems to have some anti-inflammatory activity (demonstrated by reductions in TP, WBCC and general MMP activity) up to 2 weeks post treatment but not at 4 weeks. This anti-inflammatory effect appeared to outlast a shorter-lived, potentially detrimental effect illustrated by increased synovial GAG and PGE levels after the first induction.
© 2020 EVJ Ltd.
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Publication Date: 2020-12-30 PubMed ID: 33280164DOI: 10.1111/evj.13396Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Veterinary

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research investigated the anti-inflammatory effects of a widely-used joint inflammation treatment known as intra-articular triamcinolone acetonide (TA) using an equine model, concluding that the treatment has some anti-inflammatory activity lasting up to two weeks.

Study Methodology

  • The study is a randomised controlled experimental investigation using a model of repeated joint inflammation across eight horses.
  • Inflammation was induced in all horse subjects for three consecutive cycles that were spaced two weeks apart. The method of inflammation induction involved injecting 0.25 ng of lipopolysaccharide into both middle carpal joints of the horses.
  • After the first round of inflammation induction, one joint in each horse was treated with 12 mg of triamcinolone acetonide (TA). The contralateral joint was instead treated with sterile saline, acting as a control.

Evaluation of Treatment Effects

  • The paper presents a detailed analysis of clinical parameters and synovial fluid samples at set timepoints (0, 8, 24, 72, and 168 hours post-injection).
  • Statistical testing was performed on the gathered data to gauge the impacts of time and treatment on the recorded parameters. The statistical model used accounted for repeated measures, treating time and treatment as fixed effects, and the horse as a random effect.

Findings

  • The study informs that joints treated with TA showed a significant increase in peak synovial Glycosaminoglycans (GAG) concentrations and Prostaglandin E (PGE) levels after the first inflammation induction.
  • The TA treatment also resulted in significantly lower Total Protein (TP) levels after the second inflammation induction, and notably lower White Blood Cell Count (WBCC) levels after the first and second inflammation inductions.
  • A significant reduction in Matrix Metalloproteinase (MMP) activity was noted with TA treatment after the second round of inflammation inductions.

Conclusions

  • The research highlights the limitations of the study, noting that the experiment does not fully express natural joint disease.
  • The findings overall suggest that intra-articular TA possesses some anti-inflammatory activity, demonstrated by reductions in TP, WBCC, and general MMP activity. However, this activity only appears to last up to two weeks post-treatment and not up to four weeks.
  • An interesting observation noted by the study is a shorter-lived, potentially harmful effect indicated by the increased synovial GAG and PGE levels after the initial inflammation induction.

Cite This Article

APA
Kearney CM, Korthagen NM, Plomp SGM, Labberté MC, de Grauw JC, van Weeren PR, Brama PAJ. (2020). Treatment effects of intra-articular triamcinolone acetonide in an equine model of recurrent joint inflammation. Equine Vet J, 53(6), 1277-1286. https://doi.org/10.1111/evj.13396

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 6
Pages: 1277-1286

Researcher Affiliations

Kearney, Clodagh M
  • UCD School of Veterinary Medicine, University College Dublin, Dublin, Ireland.
Korthagen, Nicoline M
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
Plomp, Saskia G M
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
Labberté, Margot C
  • UCD School of Veterinary Medicine, University College Dublin, Dublin, Ireland.
de Grauw, Janny C
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
van Weeren, P R
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
Brama, Pieter A J
  • UCD School of Veterinary Medicine, University College Dublin, Dublin, Ireland.

MeSH Terms

  • Animals
  • Horse Diseases / drug therapy
  • Horses
  • Inflammation / chemically induced
  • Inflammation / drug therapy
  • Inflammation / veterinary
  • Injections, Intra-Articular / veterinary
  • Synovial Fluid
  • Triamcinolone Acetonide / therapeutic use

Grant Funding

  • LLP-22 / Dutch Arthritis Association
  • UCD Foundation
  • UCD WELLCOME Institutional Strategic Support Fund Clinical Primer Scheme

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Citations

This article has been cited 4 times.
  1. Kearney CM, Khatab S, van Buul GM, Plomp SGM, Korthagen NM, Labberté MC, Goodrich LR, Kisiday JD, Van Weeren PR, van Osch GJVM, Brama PAJ. Treatment Effects of Intra-Articular Allogenic Mesenchymal Stem Cell Secretome in an Equine Model of Joint Inflammation. Front Vet Sci 2022;9:907616.
    doi: 10.3389/fvets.2022.907616pubmed: 35812845google scholar: lookup
  2. Duggan MJS, Kearney C, Baltrimaite M, Labberté MC, Gibney R, Brama PAJ. Refinement of the Lipopolysaccharide-Induced Synovitis Model in Equine Middle Carpal Joints. Animals (Basel) 2025 Aug 22;15(17).
    doi: 10.3390/ani15172474pubmed: 40941269google scholar: lookup
  3. Scheike AS, Plomp S, Fugazzola MC, Meurot C, Berenbaum F, van Weeren PR, Tryfonidou MA, von Hegedus JH. The Anti-Inflammatory Effects of Liraglutide in Equine Inflammatory Joint Models. J Orthop Res 2025 May;43(5):893-903.
    doi: 10.1002/jor.26050pubmed: 39904754google scholar: lookup
  4. Kearney CM, Korthagen NM, Plomp SGM, Labberté MC, de Grauw JC, van Weeren PR, Brama PAJ. A Translational Model for Repeated Episodes of Joint Inflammation: Welfare, Clinical and Synovial Fluid Biomarker Assessment. Animals (Basel) 2023 Oct 12;13(20).
    doi: 10.3390/ani13203190pubmed: 37893914google scholar: lookup
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