Inhibition of interleukin-8 synthesis by intraarticular methotrexate therapy in patients with rheumatoid arthritis.
5 Patients with definite RA and knee effusions under constant doses of DMARD therapy were treated with up to 6 intraarticular injections of 10 mg methotrexate (MTX) every 3 to 7 days. A matched randomized control group who received a single i.a. injection of 40 mg triamcinolone hexacetonide (TC) was monitored according to the same protocol. The intraarticular granulocyte counts and IL-8 levels decreased in all MTX treated patients on day 10-13 and stayed low in those patients who could be re-evaluated after 13 weeks. Compared to the IL-8 levels, the other tested cytokine levels showed only minor changes on day 10-13. There was no need for re-injection in the TC group during the 13 week study phase. We conclude that intraarticular MTX therapy results in a strong decrease of SF-granulocyte counts. This effect may be due to the impairment of IL-8 mediated chemotaxis by decreased IL-8 synthesis in synovial fluid mononuclear cells. Clinically, repeated intraarticular MTX therapy results in a worse 13 week outcome than i.a. steroid treatment measured in an intention-to-treat analysis.
Gao
I K
IK
Rheumazentrum Baden-Baden present affiliation: Klinik für Rheumakranke.
Leins
C
C
Bohlen
H
H
Heilig
B
B
Lemmel
E M
EM
D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D016209:Interleukin-8 / Q000037:antagonists & inhibitors* / Q000097:blood; D007719:Knee Joint / Q000187:drug effects / Q000276:immunology; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D013582:Synovial Fluid / Q000187:drug effects / Q000276:immunology
D018501:Antirheumatic Agents; D016209:Interleukin-8; D008727:Methotrexate