The role of steroids in the treatment of rheumatoid arthritis is being reassessed following the suggestion that their early use may reduce joint damage. Intra-articular steroids form a valuable adjunct to other therapies, because of their high success rates (about 85% of patients gain pain relief after shoulder or knee injection) and because they induce confidence in a treatment plan. Adverse reactions are rarely significant with this route of administration. It is therefore interesting to examine a new intra-articular steroid which may have advantages over existing agents. Does rimexolone work? Results from animal studies are encouraging, but the rimexolone doses used appear to be high. These observations contrast with findings of a dose-ranging clinical study in the rheumatoid knee. The superiority of rimexolone over placebo in this study is impressive, as the placebo response to injection is usually about 50% in this setting. The subjective improvement was confirmed on sonography. Comparative data in osteoarthritis of the knee, a condition often less responsive to intra-articular steroids, showed rimexolone 40mg to be superior to placebo and as effective as triamcinolone acetonide 40mg. Further studies have involved small joints of the rheumatoid hand and periarticular injections. Does rimexolone have significant adverse effects? Adverse effects of intra-articular steroids are infrequent, but infection, chemical synovitis, osteonecrosis, flushing and systemic steroidal adverse effects have been reported. The absence of skin thinning in animals after topical administration of rimexolone, and its relative lack of effects on liver glycogen and electrolyte excretion, are of interest and suggest some dissociation of its benefits from the usual steroid adverse effects. If osteonecrosis is akin to skin atrophy after topical fluorinated steroid application, rimexolone may prove to be better tolerated at the site of injection than existing agents. BioDrugs 1997Feb; 7 (2): 164-165 1173-8804/97/OOO2-0164/S01.oo/0

DOI: 10.2165/00063030-199707020-00009

Cite this paper

@article{Dequeker2012Rimexolone, title={Rimexolone}, author={Jan Dequeker}, journal={BioDrugs}, year={2012}, volume={7}, pages={164-165} }