Document Detail


Efficacy and safety of combining intra-articular methylprednisolone and anti-TNF agent to achieve prolonged remission in patients with recurrent inflammatory monoarthritis.
MedLine Citation:
PMID:  20363657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To control local inflammation, the role of intra-articular corticosteroid is well established; similarly, with time there are more reports on the experience of intra-articular anti-TNF agent for localized joint inflammation. The aim of this study was to assess the safety, local tolerability and clinical response after combining intra-articular administration of corticosteroids and anti-TNF agents for recurrent inflammatory monoarthritis. METHODS: Patients with recurrent monoarthritis of the knee were recruited from our inflammatory arthritis clinics. These patients required intra-articular corticosteroids every 8-12 weeks, with good short-term results. Five such consecutive patients were invited to partake in this study. Patients were maintained on their baseline immunosuppressive therapy. After aspiration of knee joint, the involved joint was injected with 80mg of methylprednisolone mixed with 5ml of lignocaine 1%; this was followed by the injection of an anti-TNF agent. RESULTS: In majority of our patients (three out of five), combining anti-TNF agent and methylprednisolone led to prolonged anti-inflammatory response, and these patients remain in remission to date (mean follow-up of 12 months). These responders were noted to be naive to anti-TNF therapy. Conversely, the remaining two patients were found to be on baseline systemic anti-TNF therapy, and both of them failed to respond either partly or completely. CONCLUSION: Combining intra-articular corticosteroid and anti-TNF agent has proved to be safe in our cohort of patients. We conclude that in particular subset of patients who suffer from recurrent inflammatory monoarthritis or oligoarthritis, combination therapy of intra-articular corticosteroids and anti-TNF agents appears attractive and promising.
Authors:
Muhammad Haroon; Donncha O'Gradaigh
Related Documents :
15086487 - Treatment of refractory wegener's granulomatosis with antithymocyte globulin (atg): an ...
22369077 - Confidentiality: against disguise, for consent.
22375077 - How family caregivers' medical and moral assumptions influence decision making for pati...
15341697 - Splenectomy in immune thrombocytopenic purpura: recent controversies and long-term outc...
9000037 - Cerebrospinal fluid interleukin-6 in progressive neuro-behçet's syndrome.
18426347 - Pseudomonas aeruginosa susceptible only to colistin in intensive care unit patients.
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-04-03
Journal Detail:
Title:  Joint, bone, spine : revue du rhumatisme     Volume:  77     ISSN:  1778-7254     ISO Abbreviation:  Joint Bone Spine     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100938016     Medline TA:  Joint Bone Spine     Country:  France    
Other Details:
Languages:  eng     Pagination:  232-4     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
Affiliation:
Department of Rheumatology, Waterford Regional Hospital, Waterford, Ireland. mharoon301@hotmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents / administration & dosage*
Antibodies, Monoclonal / administration & dosage*
Arthritis / drug therapy*,  immunology
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Immunoglobulin G / administration & dosage
Injections, Intra-Articular
Isoxazoles / administration & dosage
Knee Joint / drug effects,  immunology
Male
Methylprednisolone / administration & dosage*
Middle Aged
Receptors, Tumor Necrosis Factor / administration & dosage
Recurrence / prevention & control
Remission Induction
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Immunoglobulin G; 0/Isoxazoles; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 0/adalimumab; 185243-69-0/TNFR-Fc fusion protein; 75706-12-6/leflunomide; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Elevated hydroxyacylcarnitines in a carrier of LCHAD deficiency during acute liver disease of pregna...
Next Document:  Watch out for headaches at the end of a pregnancy! Do not miss an autoimmune hypositys.