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Ophthalmologica. Journal International... 2011to provide an update on the intravitreal use of triamcinolone acetonide. (Review)
Review
BACKGROUND
to provide an update on the intravitreal use of triamcinolone acetonide.
METHODS
Review of literature regarding triamcinolone-related research.
RESULTS
after the introduction of bevacizumab and ranibizumab into clinical practice, intravitreal triamcinolone has lost its leading position as the drug most often injected intravitreally. Due to its properties as a long-acting steroid, triamcinolone has still been used for various conditions such as diffuse diabetic macular edema, retinal vein occlusions, pseudophakic cystoid macular edema, chronic prephthisical ocular hypotony and uveitis, and in combination with bevacizumab or ranibizumab. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected, cataract and postoperative infectious or noninfectious endophthalmitis.
CONCLUSIONS
due to its widespread biological effects as a steroid and due to a relatively large therapeutic window, intravitreal triamcinolone has remained in clinical use for a variety of intraocular disorders, and it may be a promising candidate for intravitreal medical combination therapies.
Topics: Glucocorticoids; Humans; Intravitreal Injections; Ocular Hypertension; Ocular Hypotension; Retinal Diseases; Triamcinolone Acetonide
PubMed: 20693817
DOI: 10.1159/000317909 -
BMC Surgery May 2021Although multiple methods have been proposed to treat auricular keloids, low curative effects and high recurrence rates are currently major clinical problems. Thereinto,...
BACKGROUND
Although multiple methods have been proposed to treat auricular keloids, low curative effects and high recurrence rates are currently major clinical problems. Thereinto, surgery combined with radiotherapy and triamcinolone acetonide injection is considered to be the proper choice for comprehensive treatment of auricular keloids. This study aimed at evaluating the therapeutic effect of individualized surgery combined with radiotherapy for the treatment of auricular keloids.
METHODS
From February 2014 to February 2017, 67 patients with 113 auricular keloids in total were enrolled in this study. According to specific conditions of lesions, the local tissue and patients' individual wishes, different surgical methods were selected to analyze the scar excision and repairment of the defect. Within 24 h after the keloid was excised, 5 MeV electron beam irradiation by the linear accelerator was used by radiotherapy with a total dose of 20 Gy at interval of 1 day for 10 consecutive times. Triamcinolone acetonide was injected immediately after surgery, and per month afterward in the following three months.
RESULTS
113 keloids in total were received treatment. The follow-up period was 24 months. Fourteen keloids (12.39%) showed subjective recurrence with a success rate of 87.61%. Wilcoxon matched-pairs rank-sum test was used to compare the differences of the 24-month postoperative VSS scores and the preoperative VSS scores. The VSS scores were as follows: 82 keloids (72.57%) scored less than 5 points (good result), 21 keloids (18.58%) scored 6 to 10 points (fair result), and only 10 keloids (8.85%) scored more than 10 points (bad result). The effective rate was 91.15%.
CONCLUSIONS
Individualized surgery combined with early postoperative radiotherapy and triamcinolone acetonide injection is an ideal treatment method to ensure good auricular appearance, low incidences of complications and recurrence based on effective treatment of auricular keloids.
Topics: Combined Modality Therapy; Humans; Keloid; Recurrence; Treatment Outcome; Triamcinolone Acetonide
PubMed: 34022880
DOI: 10.1186/s12893-021-01253-9 -
Drugs Sep 2022Triamcinolone acetonide injectable suspension for suprachoroidal use (Xipere; SCS triamcinolone acetonide) is a corticosteroid approved in the USA for the treatment of... (Review)
Review
Triamcinolone acetonide injectable suspension for suprachoroidal use (Xipere; SCS triamcinolone acetonide) is a corticosteroid approved in the USA for the treatment of macular edema associated with uveitis. Suprachoroidal injection of SCS triamcinolone acetonide results in preferential distribution into the posterior segment, which may reduce the risk of corticosteroid-related adverse events, such as cataracts and intraocular pressure (IOP) elevation. In a multicenter phase III trial in patients with non-infectious uveitic macular edema, SCS triamcinolone acetonide significantly and rapidly improved visual acuity and reduced signs of macular edema compared with sham treatment. SCS triamcinolone acetonide was generally well tolerated, with the most common adverse event being eye pain on the day of the procedure. The risk of corticosteroid-related IOP elevation appeared to be reduced in unrescued patients in the SCS triamcinolone acetonide group compared with patients in the sham control group who received rescue therapy. SCS triamcinolone acetonide is a novel and useful treatment option for uveitic macular edema.
Topics: Humans; Choroidal Effusions; Glucocorticoids; Intraocular Pressure; Macular Edema; Multicenter Studies as Topic; Tomography, Optical Coherence; Treatment Outcome; Triamcinolone Acetonide; Uveitis
PubMed: 36018461
DOI: 10.1007/s40265-022-01763-7 -
BMC Ophthalmology Jun 2021We aimed to evaluate the efficacy and safety of phacoemulsification with intravitreal 3 mg triamcinolone acetonide injection in preventing postoperative inflammation...
Intraoperative intravitreal triamcinolone acetonide injection for prevention of postoperative inflammation and complications after phacoemulsification in patients with uveitic cataract.
BACKGROUND
We aimed to evaluate the efficacy and safety of phacoemulsification with intravitreal 3 mg triamcinolone acetonide injection in preventing postoperative inflammation and complications in patients with non-infectious anterior uveitis and panuveitis complicated cataract.
METHOD
In this retrospective cohort study, 140 uveitic cataract patients who received phacoemulsification and intraocular lens implantation in Shanxi Eye hospital from January 2018 to January 2020 were reviewed. The IVTA group (51 eyes of 41 patients) received intravitreal injection of 3 mg triamcinolone acetonide (TA) at the end of surgery, and the control group (51 eyes of 41 patients) without injection matched by propensity score matching were enrolled. Outcome measures were best corrected visual acuity (BCVA), anterior chamber inflammation, intraocular pressure, corneal endothelial cell density, central macular thickness and complications within 3 months follow-up.
RESULTS
The degree of postoperative anterior chamber inflammation in the IVTA group was lighter than that in the control group (P < 0.05). The postoperative logMAR BCVA of anterior uveitis was better and improved more quickly in the IVTA group(P < 0.05). Postoperative time of using corticosteroids was shorter in the IVTA group as compared to the control group (P < 0.05). The central macular thickness at postoperative month 1 was statistically significantly lower in the IVTA group (P < 0.05). There were no statistically significant differences between the two groups in postoperative corneal endothelial cell density and intraocular pressure (P > 0.05). Two of 51 eyes (3.9%) in the IVTA group and 8 of 51 eyes (15.7%) in the control group had recurrence of uveitis; 6 of 45 eyes (13.3%) in the control group developed cystoid macular edema but none in the IVTA group; 11 of 51 eyes (21.6%) in the IVTA group and 22 of 51 eyes (43.1%) in the control group developed posterior synechiae postoperatively.
CONCLUSIONS
Intraoperative Intravitreal injection of 3 mg TA is an effective and safe adjunctive therapy for preventing postoperative inflammation and complications to promote early recovery for anterior uveitis or panuveitis complicated cataract patients following phacoemulsification.
TRIAL REGISTRATION
This retrospective cohort study was in accordance with the tenets of the Helsinki Declaration and was approved by the Shanxi Eye Hospital Ethics Committee. Written informed consent was obtained from all participants for their clinical records to be used in this study.
Topics: Cataract; Glucocorticoids; Humans; Inflammation; Intravitreal Injections; Phacoemulsification; Retrospective Studies; Triamcinolone Acetonide; Uveitis; Visual Acuity; Vitreous Body
PubMed: 34088282
DOI: 10.1186/s12886-021-02017-y -
Drugs Mar 2019Triamcinolone acetonide extended-release (ER) 32 mg (Zilretta) is approved in the USA for the management of osteoarthritis (OA) pain of the knee and is administered as... (Review)
Review
Triamcinolone acetonide extended-release (ER) 32 mg (Zilretta) is approved in the USA for the management of osteoarthritis (OA) pain of the knee and is administered as a single, 5 mL intra-articular (IA) injection. Although the therapeutic effects from IA corticosteroids are typically short-lived, triamcinolone acetonide ER is formulated in poly (lactic-co-glycolic acid) (PLGA) microspheres that slowly release triamcinolone acetonide in the synovium, enabling their prolonged presence in the joint. This reduces systemic exposure and lessens corticosteroid-related systemic adverse reactions, such as blood glucose elevations. In a 24-week, randomized, phase III clinical trial, triamcinolone acetonide ER 32 mg significantly improved mean average daily pain intensity in patients with knee OA relative to placebo, and pain, stiffness and physical function (according to WOMAC criteria) relative to placebo and triamcinolone acetonide crystalline suspension (CS). Triamcinolone acetonide ER was generally well tolerated, with a tolerability profile similar to that of triamcinolone acetonide CS and placebo. Findings from a single-arm phase IIIb study indicated that a repeat administration of triamcinolone acetonide ER may be similarly efficacious to an initial injection without having deleterious effects on cartilage or other aspects of joint structure. Thus, triamcinolone acetonide ER expands the treatment options available for the management of OA pain of the knee.
Topics: Clinical Trials, Phase III as Topic; Delayed-Action Preparations; Drug Approval; Drug Delivery Systems; Humans; Injections, Intra-Articular; Osteoarthritis, Knee; Pain; Polylactic Acid-Polyglycolic Acid Copolymer; Randomized Controlled Trials as Topic; Synovial Membrane; Triamcinolone Acetonide; United States; United States Food and Drug Administration
PubMed: 30847805
DOI: 10.1007/s40265-019-01083-3 -
Molecules (Basel, Switzerland) Jul 2023Principles of quality by design and design of experiments are acquiring more importance in the discovery and application of new drug carriers, such as solid lipid...
Principles of quality by design and design of experiments are acquiring more importance in the discovery and application of new drug carriers, such as solid lipid nanoparticles. In this work, an optimized synthesis of solid lipid nanoparticles loaded with Triamcinolone Acetonide is presented using an approach that involves Stearic Acid as a lipid, soy PC as an ionic surfactant, and Tween 80 as a nonionic surfactant. The constructed circumscribed Central Composite Design considers the lipid and nonionic surfactant quantities and the sonication amplitude in order to optimize particle size and Zeta potential, both measured by means of Dynamic Light Scattering, while the separation of unentrapped drug from the optimized Triamcinolone Acetonide-loaded solid lipid nanoparticles formulation is performed by Size Exclusion Chromatography and, subsequently, the encapsulation efficiency is determined by HPLC-DAD. The proposed optimized formulation-with the goal of maximizing Zeta potential and minimizing particle size-has shown good accordance with predicted values of Zeta potential and dimensions, as well as a high value of encapsulated Triamcinolone Acetonide. Experimental values obtained from the optimized synthesis reports a dimension of 683 ± 5 nm, which differs by 3% from the predicted value, and a Zeta potential of -38.0 ± 7.6 mV (12% difference from the predicted value).
Topics: Triamcinolone Acetonide; Nanoparticles; Drug Carriers; Particle Size; Surface-Active Agents
PubMed: 37570717
DOI: 10.3390/molecules28155747 -
Diseases of the Esophagus : Official... Dec 2022The role of triamcinolone acetonide (TA) in the prevention of esophageal stricture is not well established. This meta-analysis aimed to evaluate its safety and efficacy... (Meta-Analysis)
Meta-Analysis
AIM
The role of triamcinolone acetonide (TA) in the prevention of esophageal stricture is not well established. This meta-analysis aimed to evaluate its safety and efficacy for the prevention of esophageal stricture after endoscopic submucosal dissection (ESD).
METHODS
A comprehensive search was performed in electronic databases including PubMed, the Cochrane Library, Embase for possible controlled studies. The primary outcomes were stenosis rate and endoscopic balloon dilatation (EBD) sessions required, and secondary outcome included complications. Random effects were used to calculate the pooled outcome. Sensitivity analysis and publication bias were conducted to verify the robustness and reliability of the results. Results: Ten studies containing 499 patients were obtained. In the pooled analysis, statistical significance was found in triamcinolone acetonide injection reduced the incidence of stenosis (OR = 0.29, 95% CI [0.11, 0.80], P < 0.05) and the number of endoscopic balloon dilation (MD = -3.33, 95% CI [-4.15, -2.50], P < 0.0001) compared with control. Triamcinolone acetonide injection therapy did not increase the risk of complications (OR = -0.77%, CI [-1.62, 0.09], P = 0.08). Subgroup analysis indicated that the single injection of triamcinolone acetonide after endoscopic submucosal dissection significantly reduced the incidence of stenosis compared with without any prophylaxis. Different concentrations and single session volume of triamcinolone acetonide reduced the incidence of stenosis. It also showed that the dose according to the size of the lesion was more effective than the fixed dose in preventing esophageal stricture. Conclusion: Triamcinolone acetonide injection can reduce the incidence of stricture formation as well as the need for EBD sessions without increasing complications.
Topics: Humans; Endoscopic Mucosal Resection; Esophageal Stenosis; Triamcinolone Acetonide; Treatment Outcome
PubMed: 35829658
DOI: 10.1093/dote/doac039 -
Molecular Medicine Reports Nov 2021Transforming growth factor‑β2 (TGF‑β2) has been implicated in the pathogenesis of proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy...
Transforming growth factor‑β2 (TGF‑β2) has been implicated in the pathogenesis of proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR), due to its ability to stimulate the overproduction of pro‑angiogenic factors, such as vascular endothelial growth factor (VEGF), and remodeling of the extracellular matrix (ECM). Although intravitreal triamcinolone acetonide (TA) is clinically useful in the treatment of PVR and PDR, its molecular mechanism has yet to be fully elucidated. The present study investigated whether TA treatment altered TGF‑β2‑driven biological effects on the behavior of cultured human retinal pigment epithelial (RPE) cells, in order to determine which signaling pathway may be essential for the pharmacological action of TA. The R‑50 human RPE cell line was treated with TA in the presence of TGF‑β2, followed by analyses of cell viability and contraction using cell viability and collagen gel contraction assays. VEGF mRNA expression and protein production were measured using reverse transcription‑quantitative PCR and ELISA, respectively. The phosphorylation status of signaling mediators and the protein expression of type I collagen (COL1A1), α‑smooth muscle actin (α‑SMA), and ECM‑remodeling enzymes, including MMP‑2 and MMP‑9, were analyzed using western blotting. The gelatinolytic activity of MMPs was detected using gelatin zymography. TA treatment exhibited no prominent cytotoxicity but markedly antagonized TGF‑β2‑induced cytostatic effects on RPE cell viability and TGF‑β2‑enhanced contractility in collagen gels. In the context of TGF‑β2‑related signaling, TA significantly attenuated TGF‑β2‑elicited Smad2, extracellular‑regulated kinase (ERK)1/2 and p38 mitogen‑activated protein kinase (MAPK) phosphorylation. Moreover, TA markedly mitigated TGF‑β2‑induced VEGF upregulation through ablation of p38 signaling activity. TA also partially attenuated TGF‑β2‑elicted expression of COL1A1, α‑SMA, MMP‑2, and MMP‑9, but only suppressed TGF‑β2‑induced MMP‑9 gelatinolytic activity. Mechanistically, the MEK/ERK signaling pathway may have a critical role in the TGF‑β2‑induced upregulation of COL1A1, α‑SMA and MMP‑9. In conclusion, TA may be considered a useful therapeutic agent for treating TGF‑β2‑associated intraocular angiogenesis and tissue remodeling, the underlying mechanism of which may involve the ERK and p38 MAPK signaling pathways.
Topics: Cell Culture Techniques; Cell Line; Cell Movement; Cell Survival; Collagen; Epithelial Cells; Epithelial-Mesenchymal Transition; Extracellular Matrix; Humans; MAP Kinase Signaling System; Neovascularization, Physiologic; Phosphorylation; Retinal Pigment Epithelium; Retinal Pigments; Signal Transduction; Transforming Growth Factor beta2; Triamcinolone Acetonide; Vascular Endothelial Growth Factor A; p38 Mitogen-Activated Protein Kinases
PubMed: 34523693
DOI: 10.3892/mmr.2021.12442 -
Acta Ophthalmologica Scandinavica Dec 2005Intravitreal triamcinolone acetonide (IVTA) has increasingly been applied as treatment for various intraocular neovascular and oedematous diseases. Comparing the various... (Review)
Review
Intravitreal triamcinolone acetonide (IVTA) has increasingly been applied as treatment for various intraocular neovascular and oedematous diseases. Comparing the various diseases with respect to effect and side-effects of the treatment, the best response in terms of gain in visual acuity (VA) has been achieved for intraretinal oedematous diseases such as diffuse diabetic macular oedema, branch retinal vein occlusion, central retinal vein occlusion and pseudophakic cystoid macular oedema. In eyes with various types of non-infectious uveitis, including acute or chronic sympathetic ophthalmia and Adamantiadis-Behcet's disease, VA increased and the degree of intraocular inflammation decreased. Some studies have suggested that intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischaemic retinopathies. Intravitreal triamcinolone may possibly be helpful as adjunct therapy for exudative age-related macular degeneration (AMD), particularly in combination with photodynamic therapy. In eyes with chronic, therapy-resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure (IOP) and may stabilize the eye. The complications of intravitreal triamcinolone therapy include: secondary ocular hypertension in about 40% of the eyes injected; medically uncontrollable high IOP leading to antiglaucomatous surgery in about 1-2% of the eyes; posterior subcapsular cataract and nuclear cataract leading to cataract surgery in about 15-20% of elderly patients within 1 year of injection; postoperative infectious endophthalmitis occurring at a rate of about one per 1000; non-infectious endophthalmitis, perhaps due to a reaction to the solvent agent, and pseudo-endophthalmitis with triamcinolone acetonide crystals appearing in the anterior chamber. Intravitreal triamcinolone injection can be combined with other intraocular surgeries, including cataract surgery, particularly in eyes with iris neovascularization. Cataract surgery performed some months after the injection does not show a markedly elevated complication rate. The injection may be repeated if the resultant benefits decrease after the initial IVTA injection. In non-vitrectomized eyes, the duration of the effect and side-effects of a single intravitreal injection of triamcinolone is about 6-9 months for a dosage of about 20 mg, and about 2-4 months for a dosage of 4 mg. So far, it has remained unclear whether the solvent agent should be removed, and if so, how.
Topics: Choroidal Neovascularization; Diabetic Retinopathy; Glucocorticoids; Humans; Injections; Intraocular Pressure; Macular Degeneration; Macular Edema; Ocular Hypertension; Triamcinolone Acetonide; Vitreous Body
PubMed: 16396641
DOI: 10.1111/j.1600-0420.2005.00592.x -
The British Journal of Ophthalmology Sep 2007Using triamcinolone acetonide without preservative may improve safety
Using triamcinolone acetonide without preservative may improve safety
Topics: Endophthalmitis; Eye Diseases; Glucocorticoids; Humans; Ophthalmic Solutions; Preservatives, Pharmaceutical; Triamcinolone Acetonide
PubMed: 17709575
DOI: 10.1136/bjo.2007.117432