Drs. van der Bijl and Teng contributed equally to this work.
Efficacy of intraarticular infliximab in patients with chronic or recurrent gonarthritis: A clinical randomized trial†
Article first published online: 29 JUN 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 7, pages 974–978, 15 July 2009
How to Cite
van der Bijl, A. E., Teng, Y. K. O., van Oosterhout, M., Breedveld, F. C., Allaart, C. F. and Huizinga, T. W. J. (2009), Efficacy of intraarticular infliximab in patients with chronic or recurrent gonarthritis: A clinical randomized trial. Arthritis & Rheumatism, 61: 974–978. doi: 10.1002/art.24513
- Issue published online: 29 JUN 2009
- Article first published online: 29 JUN 2009
- Manuscript Accepted: 26 MAR 2009
- Manuscript Received: 25 AUG 2008
- Schering-Plough BV
- Centocor, Inc.
To evaluate the efficacy and safety of intraarticular infliximab compared with intraarticular methylprednisolone in patients with gonarthritis.
In 23 patients with recurrent gonarthritis despite previous intraarticular corticosteroid therapy, a total of 41 intraarticular injections (20 infliximab and 21 methylprednisolone) were performed in 28 knees. Initial therapy was randomly assigned, and crossover therapy was eligible within 3 months. The clinical effect was assessed during 6 months of followup. The primary outcome was event-free survival, defined as the time after treatment until local retreatment was performed and/or nonimprovement of the knee joint score. Adverse effects were recorded during followup.
All patients treated with intraarticular infliximab had an insufficient response. In contrast, 8 of the 21 intraarticular methylprednisolone injections were effective (P = 0.004). Between groups, no differences in the patients' age, disease duration, number of disease-modifying antirheumatic drugs, or previous intraarticular methylprednisolone were observed. Reported adverse effects were not related to therapy.
Treatment with intraarticular infliximab injection was not effective in patients with a chronically inflamed knee joint. Intraarticular injection with methylprednisolone was superior despite previous intraarticular corticosteroid therapy. Further investigation is needed to provide these patients with a better alternative.