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RESEARCH PRODUCT
Safety and efficacy of intra-articular anti-tumor necrosis factor α agents compared to corticosteroids in a treat-to-target strategy in patients with inflammatory arthritis and monoarthritis flare
Francesco CarubbiPiero RuscittiMaria Letizia PistoiaLorenzo Maria GregoriFrancesco CicciaVasiliki LiakouliArmando ConchigliaGiovanni TrioloPaola CiprianiLuigi ZugaroRoberto GiacomelliCristino D'anniballeCarlo Masciocchisubject
0301 basic medicineMalerheumatoid arthritispsoriatic arthritimagnetic resonance imaging (MRI)anti-tumor necrosis factor α agent; intra-articular injection; magnetic resonance imaging (MRI); psoriatic arthritis; rheumatoid arthritis; treat-to-target strategy; ultrasonography; Pharmacology; Immunology; Immunology and AllergyInflammatory arthritisAnti-Inflammatory Agentsanti-tumor necrosis factor α agentInjections Intra-ArticularArthritis Rheumatoid0302 clinical medicineAdrenal Cortex HormonesImmunology and Allergyintra-articular injectionpsoriatic arthritismedicine.diagnostic_testultrasonographyMiddle AgedArthralgiaRheumatoid arthritisJoint painAntirheumatic AgentsCorticosteroidTumor necrosis factor alphaFemalemedicine.symptomAdultmedicine.medical_specialtymedicine.drug_classImmunology03 medical and health sciencesPsoriatic arthritisInternal medicineMonoarthritismedicineHumansImmunologic FactorsAged030203 arthritis & rheumatologyPharmacologybusiness.industryTumor Necrosis Factor-alphaArthritis PsoriaticMagnetic resonance imagingOriginal Articlesrheumatoid arthritimedicine.diseaseSurgerytreat-to-target strategy030104 developmental biologybusinessdescription
The aim of this study was to assess safety and efficacy of ultrasonography (US)-guided intra-articular injections using tumor necrosis factor (TNF) blockers compared to corticosteroids in rheumatoid arthritis (RA) or psoriatic arthritis (PsA) patients, experiencing refractory monoarthritis despite the current systemic therapy. Eighty-two patients were randomized to receive three intra-articular injections monthly of either corticosteroid or TNF blockers. Primary endpoints were the safety and an improvement greater than 20% for visual analogic scales of involved joint pain in patients injected with anti-TNFα. Further clinical, US, and magnetic resonance imaging (MRI) evaluations were considered secondary endpoints. Intra-articular TNF blockers are a safe strategy, determining a significant reduction of patient and physician reported clinical outcomes and US/MRI scores, in RA and PsA patients, when compared to intra-articular injections of corticosteroids. US guidance excluded the possibility to inject the drug in the wrong site, maximizing local effects, reducing systemic effects, and increasing the safety of the procedure. Patients with inflammatory monoarthritis could be successfully treated with US-guided intra-articular TNF blockers that are a safe and well tolerated procedure, to achieve a longstanding clinical and radiological good clinical response and/or disease remission.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-12-18 |