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首页> 外文期刊>International journal of clinical rheumatology. >Intra-articular infliximab in DMARD-resistant knee monoarthritis: clinical and ultrasound responses
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Intra-articular infliximab in DMARD-resistant knee monoarthritis: clinical and ultrasound responses

机译：DMARD耐药性膝关节炎的关节内英夫利昔单抗：临床和超声反应

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Aim: Intra-articular (ia.) injection of steroid and systemic DMARD therapy are standard treatments for inflammatory knee monoarthritis. Reports suggest that ia. infliximab (INF) may be beneficial in refractory cases. We aimed to investigate the optimum use of this therapy. Materials & methods: A total of 14 patients with knee monoarthritis, despite DMARD and NSAID treatment, were treated with up to three ia. injections of INF. Clinical and ultrasound measures were recorded for up to 1 year. The primary response was an improvement in composite knee score by at least two points within 12 weeks and deemed clinically useful if maintained for more than 8 weeks. Pretreatment with ia. methylprednisolone was utilized in some cases, to try to prolong duration of response to INF. Results: All patients responded to the first INF injection and 11 (78.6%) achieved a clinically useful response. Three out of 14 remained in remission at 1 year, 11 of the 14 relapsed and were retreated. Of these, all achieved the primary response, 70% a clinically useful response and one remained in remission at 1 year. A total of 90% relapsed and seven received a third INF injection. Of these, 86% achieved the primary response, 50% a clinically useful response and all seven relapsed. A total of 11 ia. INF injections were preceded by methylprednisolone, but this did not improve duration of response. Ultrasound measures mirrored clinical scores in most patients and preceded clinical signs of relapse overall in 37% (synovial thickness) and 18.5% (power Doppler) by a median of 2-4 weeks. Conclusion: Repeated ia. INF appears to be an effective treatment in DMARD-resistant knee monoarthritis and remission up to 1 year was achieved in 29% of patients.
机译：目的：关节内注射类固醇和全身DMARD治疗是炎性膝关节单关节炎的标准治疗方法。报告表明，ia。英夫利昔单抗（INF）在难治性病例中可能是有益的。我们旨在研究这种疗法的最佳用法。材料和方法：尽管进行了DMARD和NSAID治疗，但总共14例膝关节单关节炎患者接受了3 ia的治疗。注射INF。记录临床和超声测量长达1年。主要反应是在12周内综合膝关节评分至少提高2分，如果维持8周以上，则被认为具有临床意义。用ia进行预处理。在某些情况下，使用甲基强的松龙试图延长对INF的反应时间。结果：所有患者均对首次INF注射有反应，其中11例（78.6％）达到了临床有用的反应。 1年后14例中有3例仍缓解，14例中有11例复发并已治愈。其中，所有患者均达到了主要缓解，其中70％为临床有用的缓解，而1年时仍处于缓解状态。共有90％的患者复发，其中7例接受了第三次INF注射。其中，有86％的患者达到了主要反应，有50％的患者获得了临床有用的反应，并且全部7例都复发了。总共11 ia。 INF注射之前是甲基强的松龙，但这并不能改善反应的持续时间。超声测量反映了大多数患者的临床评分，并且在37％（滑膜厚度）和18.5％（功率多普勒）之前总体出现了复发的临床体征，中位数为2-4周。结论：反复ia。 INF似乎是对DMARD耐药的膝关节单关节炎的有效治疗方法，在29％的患者中可达到1年的缓解。

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