Arthritis Clinical Trial
Official title:
Interventional Study: Administration of Intraarticular Injection of Infliximab in Patients With Inflammatory Arthritis Who Failed Intraarticular Injection of Corticosteroids
Intra-articular (IA) injection of medication is a common procedure in the management of
joint disorders. In particular, the procedure is effective in the treatment of inflammatory
conditions, with long acting corticosteroids most commonly used. These agents have been
shown to reduce the signs and symptoms of inflammation, expressed primarily in the synovium
of the joint, and are probably capable of slowing the progression of damage to joint
cartilage and bone in some of these inflammatory conditions. Arthritis that is refractory to
IA corticosteroid injections may respond to surgical, chemical, or, radioisotope
synovectomy, procedures in which the inflamed synovial tissue is eradicated. It has been
noted that infliximab, a monoclonal antibody directed to Tumor Necrosis Factor (TNF) - α,
has high affinity for the TNF-α rich inflamed synovium. Recently, clinical benefit from IA
injections of infliximab has been reported in some cases that were refractory to IA
injections of corticosteroids. Similarly, the effectiveness of IA infliximab in suppression
of joint inflammation has also been demonstrated in patients who could not receive systemic
therapy with infliximab. These reports examined the effect of a single injection of
infliximab100 mg injected into a large inflamed joint or 2 IA injections 24 hours apart.
We propose to further evaluate the use of IA infliximab in patients with intractable knee
monoarthritis, explore the optimal mode of its employment, and assess the degree of
infliximab systemic absorption from the IA injection. In a pilot study 40 knees will be
evaluated, 20 injected with infliximab and 20 injected with a corticosteroid comparator
reflecting the current standard of care.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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