J Arthroplasty

Hyperglycemia after intra-articular IR vs. ER corticosteroid injection for knee OA

October 1, 2024

Among patients with knee OA and T2DM, intra-articular injection of triamcinolone acetonide extended-release (TA-ER; Zilretta) was associated with a lower risk of hyperglycemia vs. TA-immediate release (TA-IR; Kenalog and generics).

This was a post-hoc analysis of a phase 2 trial involving patients with symptomatic knee OA for ≥6 months, T2DM for ≥1 year, and HbA1c ≥6.5 and ≤9.0% who were randomized to receive either TA-ER (n=18) or TA-IR (n=15) via intra-articular injection.

During postinjection days 1 to 3, the TA-ER (vs. TA-IR) group experienced:

• lower median change from baseline in maximum glucose level (92.3 vs. 169.1 mg/dL)
• reduced percentage of time with a glucose level >250 mg/dL (12% vs. 26%)
• smaller proportion of patients with maximum glucose level >250 mg/dL (50% vs. 93%)
• greater percentage of time in target glucose range (62% vs. 48%)

The TA-ER group had less glycemic variability and lower glucose spikes vs. the TA-IR group. Median times to glucose level 250 mg/dL (44 vs. 6 hours) and maximum glucose level (34 vs. 13 hours) were significantly longer in the TA-ER group.

Source:

Spitzer AI, et al. (2024, September). J Arthroplasty. Extended-Release Versus Immediate-Release Triamcinolone Acetonide in Patients Who Have Knee Osteoarthritis and Type 2 Diabetes Mellitus. https://pubmed.ncbi.nlm.nih.gov/38815874/