Intra-articular infliximab in patients with rheumatoid arthritis and psoriatic arthritis with monoarthritis resistant to local glucocorticoids. Clinical efficacy extended to patients on systemic anti-tumour necrosis factor 
1 Dipartimento di Clinica e Terapia Medica, Sezione di Reumatologia, Sapienza Università di Roma, Policlinico Umberto I, Rome, Italy
2 Unità di Medicina Nucleare, II Facoltà di Medicina, Sapienza Università di Roma, Ospedale S. Andrea, Rome, Italy
3 Dipartimento di Clinica e Terapia Medica, Sezione di Reumatologia, Sapienza Università di Roma, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
Correspondence to:
Professor Guido Valesini, Dipartimento di Clinica e Terapia Medica, Sezione di Reumatologia, Sapienza Università di Roma, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; guido.valesini@uniroma1.it
Accepted 22 March 2008
| The first 150 words of the full text of this article appear below. |
Some experiences with intra-articular (IA) infliximab treatment in patients with refractory monoarthritis have been reported, even though these studies have important limitations including small sample size and short trial duration.1–4
Aim of this study was to evaluate the efficacy and safety of IA infliximab administration in a larger cohort of patients. We studied 10 patients with rheumatoid arthritis (RA) and seven with psoriatic arthritis (PsA) with active monoarthritis lasting at least 3 months, refractory to disease-modifying antirheumatic drugs (DMARDs) and to IA glucocorticoids.5 6 DMARDs dose had to be stable for at least 6 weeks before IA injection of infliximab, and it was maintained stable throughout the follow-up. IA methylprednisolone had to have been injected at least 6 weeks before the procedure. Concomitant treatment with anti-TNF
other than infliximab was permitted; indeed the biologic agent was stopped 2 weeks before and restarted 2 weeks after IA procedure. After removing synovial fluid,
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