| Efficacy and safety of combining intra-articular methylprednisolone and anti-TNF agent to achieve prolonged remission in patients with recurrent inflammatory monoarthritis. | |
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MedLine Citation:
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PMID: 20363657 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Muhammad Haroon; Donncha O'Gradaigh |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2010-04-03 |
Journal Detail:
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Title: Joint, bone, spine : revue du rhumatisme Volume: 77 ISSN: 1778-7254 ISO Abbreviation: Joint Bone Spine Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-25 Completed Date: 2010-08-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100938016 Medline TA: Joint Bone Spine Country: France |
Other Details:
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Languages: eng Pagination: 232-4 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved. |
Affiliation:
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Department of Rheumatology, Waterford Regional Hospital, Waterford, Ireland. mharoon301@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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
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