Safety of Intramuscular Triamcinolone Injections for Hidradenitis Suppurativa Flares: Findings from a Retrospective Cohort Study

Introduction Hidradenitis Suppurativa (HS) is an inflammatory skin condition that is typically managed with oral prednisone (OP). Intramuscular triamcinolone injection (ITI) therapy can control HS flares, however, the safety profile of multiple ITIs in HS is unknown. We assess the short-term and long-term risk of adverse effects after multiple ITIs in HS patients, and the one-year risk of adverse effects after receiving ITI or OP. Method Using the TriNetX Research Network between January 1, 2018, and December 31, 2019, we identified 892 HS patients who received one ITI and 892 matched HS patients who received three or more ITIs. We identified 650 HS patients who received three or more ITIs and 650 matched HS patients who received three or more regimens of 20mg OP. Results Compared to single ITI, patients with multiple ITIs did not have a significantly increased one-month or one-year risk of abnormal weight gain, skin infections, hyperglycemia, hypertension, depressive episodes, behavioral syndromes, bacterial and viral infections, or peptic ulcers. There was no increased one-year risk of hyperlipidemia, metabolic syndrome, adrenocortical insufficiency, osteoporosis, cataract, or glaucoma. Compared to OP, there was no significant difference in the one-year risk of abnormal weight gain, hyperlipidemia, osteoporosis, cataract, glaucoma, behavioral syndromes, peptic ulcers, hyperglycemia, depressive episodes, skin infections, or bacterial and viral infections. Patients with OP had a significantly higher risk of hypertension. Discussion We demonstrate that multiple ITIs do not significantly increase the short- or long-term risk of adverse corticosteroid effects compared to multiple regimens of OP or singular ITI.