https://doi.org/10.4081/reumatismo.2010.46

Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis

Vol. 62 No. 1 (2010)
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Authors

S. Bello
office@pagepress.org
C. Bonali
L. Serafino
P. Di Giuseppe
A. Minosi
N. Terlizzi
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.

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How to Cite

Bello, S., Bonali, C., Serafino, L., Di Giuseppe, P., Minosi, A., & Terlizzi, N. (2010). Intra-articular therapy with infliximab in psoriatic arthritis: efficacy and safety in refractory monoarthritis. Reumatismo, 62(1), 46–50. https://doi.org/10.4081/reumatismo.2010.46

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