title: Efficacy of intraarticular infliximab in patients with chronic or recurrent gonarthritis: a clinical randomized trial.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intraarticular infliximab compared with intraarticular methylprednisolone in patients with gonarthritis.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Leiden University Medical Centre, Leiden, The Netherlands. a.e.van_der_bijl@lumc.nl
authors: A E
authors: AE
authors: van der Bijl
authors: Y K O
authors: YK
authors: Teng
authors: M
authors: M
authors: van Oosterhout
authors: F C
authors: FC
authors: Breedveld
authors: C F
authors: CF
authors: Allaart
authors: T W J
authors: TW
authors: Huizinga
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy* / Q000503:physiopathology*; D002908:Chronic Disease; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000069285:Infliximab; D007270:Injections, Intra-Articular; D053208:Kaplan-Meier Estimate; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009426:Netherlands; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab; D008775:Methylprednisolone