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We read with interest the article by Paran and colleagues on a pilot study of a long acting somatostatin analogue for the treatment of refractory rheumatoid arthritis (RA).1 The role of peptidergic sensory neurons and the “neurogenic inflammation” in RA and, particularly, in the involvement of substance P (SP) in the articular destruction in experimental arthritis has been demonstrated.2 High levels of SP have been detected in synovial fluid3 and plasma4 samples of patients with RA. It has also been shown that somatostatin inhibits SP release from sensory nerves.5 Matucci-Cerinic et al have demonstrated that intra-articular somatostatin induces clinical improvement in patients with RA.6
We would like to report our experience, based on a pilot study of treatment for RA with somatostatin analogue (sandostatin). Eleven female patients with classical or definite RA according to American Rheumatism Association criteria were selected for this study with a mean age of 57.4 years and average duration of disease period of 14.5 years. All the patients had previously received multiple disease modifying antirheumatic drugs, but complete remission could not be achieved. Patients who had received any drug except non-steroidal anti-inflammatory drugs during the eight weeks before the start of the study, who had …