Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis
Objective: To evaluate efficacy and safety of intra-articular therapy (IA) with infliximab (IFX), in patients with psoriatic arthritis (PsA) and refractory monoarthritis. Methods: Four male and 1 female aged from 25 to 71 years and disease duration from 1 to 25 years, affected by PsA (CASPAR criteri...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2011-06-01
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| Series: | Reumatismo |
| Online Access: | http://www.reumatismo.org/index.php/reuma/article/view/462 |
| _version_ | 1818465754608041984 |
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| author | A. Minosi P. Di Giuseppe L. Serafino C. Bonali S. Bello N. Terlizzi |
| author_facet | A. Minosi P. Di Giuseppe L. Serafino C. Bonali S. Bello N. Terlizzi |
| author_sort | A. Minosi |
| collection | DOAJ |
| description | Objective: To evaluate efficacy and safety of intra-articular therapy (IA) with infliximab (IFX), in patients with psoriatic arthritis (PsA) and refractory monoarthritis. Methods: Four male and 1 female aged from 25 to 71 years and disease duration from 1 to 25 years, affected by PsA (CASPAR criteria) were observed . All patients were treated with immunomodulators (methotrexate, leflunomide, cyclosporin A), 3/5 with concomitant steroids, 4/5 with NSAID’s. Only 1 patient were treated with IFX 5 mg/kg IV every 6 weeks. Before the IFX injection an amount of synovial fluid was aspired from the inflamed site and the anti-TNF injection was echographic guided. Patients were evaluated at regular intervals through clinical and echographic examination and retreated in case of flare. Results: At follow-up visit after 7 days, in all patients treated with the first injection was detected total regression of the inflammation and no new inflamed synovial fluid was observed; power doppler examination shows reduction of local vascularization. Two patients experienced full remission after 6 months and only one injection, 1 patient (arthritis of the wrist) was in remission after 2 injections (3 months of interval). In 2 patients with knee arthritis and important synovial hypertrophy good results obtained after the first injection were not maintained afterwards and second injection was ineffective: these patients were evaluated for surgical intervention. Conclusions: Local injections of IFX were safe and well tolerated in all patients. The efficacy in short term was observed in all cases; our supposition is that presence of synovial hypertrophy is cause of worsening. |
| first_indexed | 2024-04-13T20:49:42Z |
| format | Article |
| id | doaj.art-6693831209a541309aeb47256e9d5b4f |
| institution | Directory Open Access Journal |
| issn | 0048-7449 2240-2683 |
| language | English |
| last_indexed | 2024-04-13T20:49:42Z |
| publishDate | 2011-06-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Reumatismo |
| spelling | doaj.art-6693831209a541309aeb47256e9d5b4f2022-12-22T02:30:33ZengPAGEPress PublicationsReumatismo0048-74492240-26832011-06-01621465010.4081/reumatismo.2010.46Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritisA. MinosiP. Di GiuseppeL. SerafinoC. BonaliS. BelloN. TerlizziObjective: To evaluate efficacy and safety of intra-articular therapy (IA) with infliximab (IFX), in patients with psoriatic arthritis (PsA) and refractory monoarthritis. Methods: Four male and 1 female aged from 25 to 71 years and disease duration from 1 to 25 years, affected by PsA (CASPAR criteria) were observed . All patients were treated with immunomodulators (methotrexate, leflunomide, cyclosporin A), 3/5 with concomitant steroids, 4/5 with NSAID’s. Only 1 patient were treated with IFX 5 mg/kg IV every 6 weeks. Before the IFX injection an amount of synovial fluid was aspired from the inflamed site and the anti-TNF injection was echographic guided. Patients were evaluated at regular intervals through clinical and echographic examination and retreated in case of flare. Results: At follow-up visit after 7 days, in all patients treated with the first injection was detected total regression of the inflammation and no new inflamed synovial fluid was observed; power doppler examination shows reduction of local vascularization. Two patients experienced full remission after 6 months and only one injection, 1 patient (arthritis of the wrist) was in remission after 2 injections (3 months of interval). In 2 patients with knee arthritis and important synovial hypertrophy good results obtained after the first injection were not maintained afterwards and second injection was ineffective: these patients were evaluated for surgical intervention. Conclusions: Local injections of IFX were safe and well tolerated in all patients. The efficacy in short term was observed in all cases; our supposition is that presence of synovial hypertrophy is cause of worsening.http://www.reumatismo.org/index.php/reuma/article/view/462 |
| spellingShingle | A. Minosi P. Di Giuseppe L. Serafino C. Bonali S. Bello N. Terlizzi Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis Reumatismo |
| title | Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis |
| title_full | Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis |
| title_fullStr | Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis |
| title_full_unstemmed | Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis |
| title_short | Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis |
| title_sort | intra articular therapy with infliximab in psoriatic arthritis efficacy and safety in refractory monoarthritis |
| url | http://www.reumatismo.org/index.php/reuma/article/view/462 |
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