Predictors of outcome in patients with oligoarthritis: results of a protocol of intraarticular corticosteroids to all clinically active joints.

Abstract

OBJECTIVE:

To determine the outcome and the factors that predict the persistence of synovitis following intraarticular corticosteroid injections in patients with recent-onset oligoarthritis.

METHODS:

Fifty-one patients with < or =5 joints with synovitis (disease duration < or =12 months) were treated with intraarticular injections of methylprednisolone into all joints with clinical synovitis. Predictors of outcome were sought, with the primary end point a complete response (no synovitis on clinical examination) at 12 weeks.

RESULTS:

Patient's and physician's assessments of disease activity, the swollen joint count, and function (by Health Assessment Questionnaire) were all significantly improved at 12 weeks (P < 0.001). Twenty-nine patients (57%) were judged to have had a complete response at 2 weeks. The best predictor of response at 12 and 26 weeks was the presence or absence of synovitis at 2 weeks (P = 0.002 and P = 0.004, respectively). At 52 weeks of followup, nearly 50% of the patients still had evidence of synovitis.

CONCLUSION:

Intraarticular corticosteroids are an effective treatment for early oligoarthritis, but there is still a high level of long-term morbidity. Failure to respond by 2 weeks indicates a high likelihood of persistent disease, and this is relevant when producing management guidelines and selecting patients for studies focusing on early intervention.

• Authors: M Green, H Marzo-Ortega, R J Wakefield, P Astin, S Proudman, P G Conaghan, L Hordon, P Emery
• Journal: Arthritis and rheumatism (Arthritis Rheum) Vol. 44 Issue 5 Pg. 1177-83 (May 2001) ISSN: 0004-3591 [Print] United States
• PMID: 11352252 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Biomarkers
• Methylprednisolone

Topics

• Adult
• Aged
• Anti-Inflammatory Agents (administration & dosage)
• Arthritis, Reactive (drug therapy)
• Biomarkers
• Female
• Follow-Up Studies
• Humans
• Injections, Intra-Articular
• Male
• Methylprednisolone (administration & dosage)
• Middle Aged
• Predictive Value of Tests
• Synovitis (drug therapy)
• Treatment Outcome