1. Efficacy of intraarticular infliximab in patients with chronic or recurrent gonarthritis: a clinical randomized trial.
- Author
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van der Bijl AE, Teng YK, van Oosterhout M, Breedveld FC, Allaart CF, and Huizinga TW
- Subjects
- Adult, Anti-Inflammatory Agents administration & dosage, Anti-Inflammatory Agents therapeutic use, Antibodies, Monoclonal administration & dosage, Antirheumatic Agents administration & dosage, Chronic Disease, Cross-Over Studies, Double-Blind Method, Female, Humans, Infliximab, Injections, Intra-Articular, Kaplan-Meier Estimate, Male, Methylprednisolone administration & dosage, Methylprednisolone therapeutic use, Middle Aged, Netherlands, Recurrence, Treatment Outcome, Antibodies, Monoclonal therapeutic use, Antirheumatic Agents therapeutic use, Arthritis drug therapy, Arthritis physiopathology, Knee Joint physiopathology
- Abstract
Objective: To evaluate the efficacy and safety of intraarticular infliximab compared with intraarticular methylprednisolone in patients with gonarthritis., Methods: In 23 patients with recurrent gonarthritis despite previous intraarticular corticosteroid therapy, a total of 41 intraarticular injections (20 infliximab and 21 methylprednisolone) were performed in 28 knees. Initial therapy was randomly assigned, and crossover therapy was eligible within 3 months. The clinical effect was assessed during 6 months of followup. The primary outcome was event-free survival, defined as the time after treatment until local retreatment was performed and/or nonimprovement of the knee joint score. Adverse effects were recorded during followup., Results: All patients treated with intraarticular infliximab had an insufficient response. In contrast, 8 of the 21 intraarticular methylprednisolone injections were effective (P = 0.004). Between groups, no differences in the patients' age, disease duration, number of disease-modifying antirheumatic drugs, or previous intraarticular methylprednisolone were observed. Reported adverse effects were not related to therapy., Conclusion: Treatment with intraarticular infliximab injection was not effective in patients with a chronically inflamed knee joint. Intraarticular injection with methylprednisolone was superior despite previous intraarticular corticosteroid therapy. Further investigation is needed to provide these patients with a better alternative.
- Published
- 2009
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