Efficacy and safety of combining intra-articular methylprednisolone and anti-TNF agent to achieve prolonged remission in patients with recurrent inflammatory monoarthritis.

Hdl Handle:
http://hdl.handle.net/10147/207950
Title:
Efficacy and safety of combining intra-articular methylprednisolone and anti-TNF agent to achieve prolonged remission in patients with recurrent inflammatory monoarthritis.
Authors:
Haroon, Muhammad; O'Gradaigh, Donncha
Affiliation:
Department of Rheumatology, Waterford Regional Hospital, Waterford, Ireland., mharoon301@hotmail.com
Citation:
Joint Bone Spine. 2010 May;77(3):232-4. Epub 2010 Apr 3.
Journal:
Joint, bone, spine : revue du rhumatisme
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207950
DOI:
10.1016/j.jbspin.2010.02.008
PubMed ID:
20363657
Abstract:
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.
Language:
eng
MeSH:
Adult; Anti-Inflammatory Agents/*administration & dosage; Antibodies, Monoclonal/*administration & dosage; Antibodies, Monoclonal, Humanized; 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
ISSN:
1778-7254 (Electronic); 1297-319X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorHaroon, Muhammaden_GB
dc.contributor.authorO'Gradaigh, Donnchaen_GB
dc.date.accessioned2012-02-01T10:52:20Z-
dc.date.available2012-02-01T10:52:20Z-
dc.date.issued2012-02-01T10:52:20Z-
dc.identifier.citationJoint Bone Spine. 2010 May;77(3):232-4. Epub 2010 Apr 3.en_GB
dc.identifier.issn1778-7254 (Electronic)en_GB
dc.identifier.issn1297-319X (Linking)en_GB
dc.identifier.pmid20363657en_GB
dc.identifier.doi10.1016/j.jbspin.2010.02.008en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207950-
dc.description.abstractOBJECTIVE: 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.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnti-Inflammatory Agents/*administration & dosageen_GB
dc.subject.meshAntibodies, Monoclonal/*administration & dosageen_GB
dc.subject.meshAntibodies, Monoclonal, Humanizeden_GB
dc.subject.meshArthritis/*drug therapy/immunologyen_GB
dc.subject.meshDrug Therapy, Combinationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshHumansen_GB
dc.subject.meshImmunoglobulin G/administration & dosageen_GB
dc.subject.meshInjections, Intra-Articularen_GB
dc.subject.meshIsoxazoles/administration & dosageen_GB
dc.subject.meshKnee Joint/drug effects/immunologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMethylprednisolone/*administration & dosageen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshReceptors, Tumor Necrosis Factor/administration & dosageen_GB
dc.subject.meshRecurrence/prevention & controlen_GB
dc.subject.meshRemission Inductionen_GB
dc.subject.meshTumor Necrosis Factor-alpha/*antagonists & inhibitorsen_GB
dc.titleEfficacy and safety of combining intra-articular methylprednisolone and anti-TNF agent to achieve prolonged remission in patients with recurrent inflammatory monoarthritis.en_GB
dc.contributor.departmentDepartment of Rheumatology, Waterford Regional Hospital, Waterford, Ireland., mharoon301@hotmail.comen_GB
dc.identifier.journalJoint, bone, spine : revue du rhumatismeen_GB
dc.description.provinceMunster-
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