title: Effectiveness of Certolizumab Pegol in Treating Rheumatoid Arthritis Patients with Persistent Inflamed Residual Mono- or Oligosynovitis Resistant to Prior TNF-α Inhibitors.
abstract: We report four cases of successful treatment with certolizumab pegol (CZP) of rheumatoid arthritis (RA) patients with persistent inflamed residual mono- or oligosynovitis resistant to prior TNF-α inhibitors. Although the patients were in a moderate disease activity, a low activity, or a remission of RA, they sustained inflammatory mono-/oligoarthritis even after treatment with prior TNF inhibitors. They were then all treated with CZP and observed in a serial ultrasonography. In all cases, the positive power Doppler signals in the joint have disappeared promptly and all of the patients were able to retain remission in the long term. The treatment of CZP to the refractory mono-/oligoarthritis of inflammatory synovitis in RA patients has not been previously described. The cases suggest that it may be associated with the feature of CZP, possible effective penetration into the site of inflammation.
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Syuichi
authors.initials: S
authors.lastname: Koarada
authors.affiliation: Nagasaki Medical Hospital of Rheumatology, 1-21 Aburaya-machi, Nagasaki 850-0832, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tsuboi
authors.affiliation: Tsuruta Rehabilitation Clinic, 174-8 Ogi-Ushizu, Saga 849-0305, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Komine
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Nakao
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tokuda
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Tashiro
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Maruyama
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ono
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Akihide
authors.initials: A
authors.lastname: Ohta
authors.affiliation: Division of Rheumatology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Tada