Seven RCTs were included, with 306 patients (range 23 to 85). All seven RCTs were rated as high quality. One did not report blinding of assessors, and one did not report a power analysis. Two trials did not report blinding of the injector. Follow-up ranged from two weeks to 24 months.
Compared with methylprednisolone or prednisolone-t-butyl acetate, for rheumatoid arthritis of the knee, triamcinolone hexacetonide demonstrated statistically significantly faster pain relief at day seven (one RCT; 30 patients). A similar result was shown when triamcinolone hexacetonide for knee osteoarthritis was compared with methylprednisolone at week three (one RCT; 57 patients). Another trial (24 patients) demonstrated significantly faster pain relief with methylprednisolone for rotator cuff tendonitis, compared with triamcinolone acetonide, at two weeks. All three trials demonstrated similar long-term efficacy of the corticosteroids for pain relief.
In trials of patients with knee arthritis, triamcinolone hexacetonide was found to have significantly better efficacy for pain relief than triamcinolone acetonide at 24 months (one RCT; 43 patients), and betamethasone at day 42 (one RCT; 23 patients). Occasional injection site pain, skin atrophy, and rise in blood glucose were the only adverse effects reported. Further results were reported.