Hydrocortistab (Hydrocortisone Acetate)

Hydrocortistab is primarily employed for localized treatment of inflammatory conditions affecting joints and surrounding tissues, where systemic therapy may be unnecessary or undesirable.

• Osteoarthritis of the knee or hip, providing short‑term pain relief and reduced swelling.
• Rheumatoid arthritis flare involving a single joint, to decrease synovial inflammation.
• Bursitis or tenosynovitis of the shoulder, elbow, or ankle, for targeted anti‑inflammatory effect.
• Post‑operative joint inflammation, to limit edema and improve early mobility.
• Acute synovitis in gout or pseudogout, to control local inflammatory response.

• Hydrocortistab delivers hydrocortisone acetate directly into the joint space, where the ester is hydrolyzed to active hydrocortisone. The active steroid binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and modulates gene transcription. This results in decreased production of pro‑inflammatory cytokines, inhibition of phospholipase A2, and reduced migration of immune cells, collectively producing potent anti‑inflammatory and immunosuppressive effects at the site of injection.

Adverse reactions to intra‑articular hydrocortisone acetate are generally related to local tissue response or systemic corticosteroid exposure.

Common

• Transient pain or burning sensation at the injection site that usually resolves within a few hours.
• Localized swelling, mild erythema, or bruising around the joint, often diminishing over several days.
• Temporary increase in joint stiffness or reduced range of motion that improves with activity or physical therapy.

Serious

• Joint infection (septic arthritis) presenting with severe pain, fever, and swelling, which requires prompt antimicrobial treatment.
• Tendon rupture or ligament weakening at the injection site, potentially leading to loss of joint stability and requiring surgical repair.
• Systemic corticosteroid effects such as elevated blood glucose levels, increased blood pressure, or mood changes, especially in patients with pre‑existing metabolic conditions.

When using Hydrocortistab, clinicians should evaluate patient history and local factors to minimize risks associated with intra‑articular corticosteroid injections.

• Assess for active infection in the joint or surrounding skin before injection.
• Avoid repeated injections in the same joint within a short interval (generally no more than 3‑4 times per year).
• Use caution in patients with diabetes, hypertension, or osteoporosis, as systemic absorption may exacerbate these conditions.
• Consider alternative therapies for pregnant or breastfeeding women, given limited safety data.
• Review concomitant anticoagulant or antiplatelet therapy to reduce bleeding risk.
• Monitor for signs of tendon or ligament weakening after the procedure.

Hydrocortistab may interact with other medications that affect coagulation, infection risk, or systemic corticosteroid exposure.

Avoid

• Concurrent intra‑articular or systemic corticosteroids, which can increase the risk of systemic side effects and tissue weakening.
• Live vaccines administered within two weeks of injection, due to potential immunosuppression.

Use with caution

• Anticoagulant or antiplatelet agents, as they may increase bleeding or hematoma formation at the injection site.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs), which can mask early signs of infection or exacerbate gastrointestinal irritation.
• Diabetic medications, because systemic absorption of corticosteroid may raise blood glucose levels and require dose adjustment.