Comparison of the effectiveness on intra-articular and subcutaneous TNF inhibitor in rheumatoid arthritis patients.

Abstract

The objective of this study is to evaluate the efficacy of single intra-articular (IA) injection of tumor necrosis factor α (TNFα) inhibitor in knee joints comparing with subcutaneous injection in rheumatoid arthritis (RA) patients. Forty-eight RA patients with 73 knee arthritis were divided into three groups, group A: received a single injection of TNF inhibitor into knee joints; group B: received regular subcutaneous injection; and group C: received both of the regimen as groups A and B. Ultrasound, erythrocyte sedimentation rate, C-reactive protein (CRP), patients' global visual analogue scale (VAS), and 28-joint Disease Activity Score (DAS28) were collected pre- and post-therapy 4 weeks. The results of the study are as follows: (1) CRP, VAS, and DAS28 of all groups improved significantly post-therapy (p < 0.05); (2) After therapy, synovial hypertrophy (SH) decreased significantly from 4.40 ± 1.86 mm to 2.74 ± 1.88 mm (p < 0.05) and power Doppler (PD) signal decreased significantly from 2.63 ± 0.75 to 1.50 ± 0.93 (p < 0.01) in group A. Synovial effusion (SE), SH, and PD showed no significant improvement in group B. SE decreased significantly from 9.84 ± 4.70 mm to 5.89 ± 4.47 mm (p < 0.05), SH decreased significantly from 4.52 ± 1.97 mm to 2.49 ± 1.73 mm (p < 0.01), and PD decreased significantly from 2.46 ± 0.66 to 1.38 ± 1.04 (p < 0.01) in group C; and (3) The improvement rate of SH and PD in both groups A and C was obviously higher than that of group B (p < 0.05). Single IA injection of TNFα inhibitor was an effective treatment in improvement of SH and PD of knee joints than subcutaneous injection in RA patients.

• Authors: Fangze Zhang, Cuili Ma
• Journal: Clinical rheumatology (Clin Rheumatol) Vol. 37 Issue 1 Pg. 199-204 (Jan 2018) ISSN: 1434-9949 [Electronic] Germany
• PMID: 28871338 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antirheumatic Agents
• Tumor Necrosis Factor-alpha

Topics

• Adult
• Antirheumatic Agents (administration & dosage, therapeutic use)
• Arthritis, Rheumatoid (diagnostic imaging, drug therapy)
• Female
• Humans
• Injections, Intra-Articular
• Injections, Subcutaneous
• Knee Joint (diagnostic imaging, drug effects)
• Male
• Middle Aged
• Synovial Membrane (diagnostic imaging, drug effects)
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)
• Ultrasonography, Doppler