1. 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
- Author
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Francesco Carubbi, Piero Ruscitti, Maria Letizia Pistoia, Lorenzo Maria Gregori, Francesco Ciccia, Vasiliki Liakouli, Armando Conchiglia, Giovanni Triolo, Paola Cipriani, Luigi Zugaro, Roberto Giacomelli, Cristino D'Anniballe, Carlo Masciocchi, Carubbi, F., Zugaro, L., Cipriani, P., Conchiglia, A., Gregori, L., Danniballe, C., Letizia Pistoia, M., Liakouli, V., Ruscitti, P., Ciccia, Francesco, Triolo, Giovanni, Masciocchi, C., Giacomelli, R., Ciccia, F., and Triolo, G.
- Subjects
0301 basic medicine ,Male ,rheumatoid arthritis ,psoriatic arthriti ,magnetic resonance imaging (MRI) ,anti-tumor necrosis factor α agent ,intra-articular injection ,psoriatic arthritis ,treat-to-target strategy ,ultrasonography ,Pharmacology ,Immunology ,Immunology and Allergy ,Inflammatory arthritis ,Anti-Inflammatory Agents ,Injections, Intra-Articular ,Arthritis, Rheumatoid ,0302 clinical medicine ,Adrenal Cortex Hormones ,medicine.diagnostic_test ,Middle Aged ,Arthralgia ,Rheumatoid arthritis ,Joint pain ,Antirheumatic Agents ,Corticosteroid ,Tumor necrosis factor alpha ,Female ,medicine.symptom ,Adult ,medicine.medical_specialty ,medicine.drug_class ,03 medical and health sciences ,Psoriatic arthritis ,Internal medicine ,Monoarthritis ,medicine ,Humans ,Immunologic Factors ,Aged ,030203 arthritis & rheumatology ,business.industry ,Tumor Necrosis Factor-alpha ,Arthritis, Psoriatic ,Magnetic resonance imaging ,Original Articles ,rheumatoid arthriti ,medicine.disease ,Surgery ,030104 developmental biology ,business - Abstract
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.
- Published
- 2015