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Letter
Treatment of resistant rheumatoid arthritis by intra-articular infliximab injections: a pilot study
  1. S N Nikas1,
  2. T I Temekonidis1,
  3. A K Zikou2,
  4. M I Argyropoulou2,
  5. S Efremidis2,
  6. A A Drosos1
  1. 1Division of Rheumatology, Department of Internal Medicine, University of Ioannina, Ioannina, Greece
  2. 2Department of Radiology, Medical School, University of Ioannina, Ioannina, Greece
  1. Correspondence to:
    Professor A A Drosos
    Division of Rheumatology, Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece; adrososcc.uoi.gr

https://doi.org/10.1136/ard.2003.006981

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    Rheumatoid arthritis (RA) is a chronic inflammatory disease which is characterised mainly by synovial inflammation and joint destruction, as well as extra-articular manifestations.1 Cytokines have a central role in the pathogenesis of this synovial inflammation. Tumour necrosis factor α (TNFα) is one of the dominant cytokines. Many studies have shown that TNFα is present in biologically significant amounts in RA synovial tissue and fluids, and the amount seems to parallel the extent of inflammation and bone erosion.2,3

    Persistent inflamed monarthritis in patients with RA is difficult to treat. Usually it is treated with local patches, intra-articular injections of steroids, or even with chemical, radioactive, or surgical synovectomy.4 The introduction of anti-TNFα treatments, especially the infusion of infliximab,5 prompted us to investigate the effectiveness and safety of intra-articular injection of infliximab in patients with RA and resistant monarthritis.

    METHODS AND RESULTS

    Five patients who fulfilled the American College of Rheumatology criteria for RA were studied.6 All were receiving treatment with …

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