Magnetic Resonance Imaging Clinical Trial
Official title:
Analysis of Antalgic Efficacy of an Intra Articular Injection of Botulinum Toxin Versus Corticoids in Gonarthrosis by Perfusion MRI:a Superiority, Randomized, Controlled, Double Blind Study
We believe we can demonstrate a link between the analgesic action of intra-articular injection of botulinum toxin and synovial inflammation by Dynamic Contrast Enhancement (DCE) perfusion Magnetic Resonance Imaging (MRI).
Knee osteoarthritis is one of the most common causes of joint pain and functional disability
in the general population.
Intra-articular infiltrations of corticoids are indicated for painful crisis especially if
accompanied of effusion. However, this effect lasts only 2 weeks.
Given the lack of effective long-term medical-infiltrative treatment, we believe that
botulinum toxin type A could be used by its direct action on mediators of neuro-gene
inflammation at the joint level and its indirect medullary action by retrograde migration.
To date, 2 published randomized controlled trials and one unpublished Phase Ib clinical trial
have shown that botulinum toxin injected intraarticularly improves pain and functionality in
gonarthrosis.
Dynamic Contrast Enhancement (DCE) Magnetic Resonance Imaging (MRI) demonstrated the
correlation between synovial inflammation and pain in gonarthrosis in a cohort of 454
subjects. It has also made it possible, via the monitoring of synovial inflammation, to
demonstrate the efficacy of treatments in patients suffering from rheumatoid arthritis in the
early phase, juvenile chronic arthritis or osteoarthritis.
DCE MRI perfusion therefore appears here as the technique of choice to follow the evolution
of synovial inflammation after botulinum toxin injection in patients with symptomatic
gonarthrosis.
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