Zhang F, et al. – The efficacy of single intra–articular (IA) injection of tumor necrosis factor α (TNFα) inhibitor in knee joints was compared with subcutaneous injection in rheumatoid arthritis (RA) patients. Outcomes confirmed that single IA injection of TNFα inhibitor was an effective treatment option for the improvement of synovial hypertrophy (SH) and power Doppler (PD) of knee joints as compared to subcutaneous injection in RA patients.

• In this study, 48 RA patients with 73 knee arthritis were divided into 3 groups, group A: received a single injection of TNF inhibitor into knee joints; group B: received regular subcutaneous injection; and group C: received both of the regimen as groups A and B.
• Ultrasound, erythrocyte sedimentation rate, C–reactive protein (CRP), patients’ global visual analogue scale (VAS), and 28–joint Disease Activity Score (DAS28) were collected pre– and post–therapy 4 weeks.
• CRP, VAS, and DAS28 of all groups improved significantly post–therapy (p < 0.05).
• After therapy, synovial hypertrophy (SH) decreased significantly from 4.40 ± 1.86 mm to 2.74 ± 1.88 mm (p < 0.05).
• Power Doppler (PD) signal decreased significantly from 2.63 ± 0.75 to 1.50 ± 0.93 (p < 0.01) in group A.
• In group B, synovial effusion (SE), SH, and PD showed no significant improvement.
• SE decreased significantly from 9.84 ± 4.70 mm to 5.89 ± 4.47 mm (p < 0.05), SH decreased significantly from 4.52 ± 1.97 mm to 2.49 ± 1.73 mm (p < 0.01), and PD decreased significantly from 2.46 ± 0.66 to 1.38 ± 1.04 (p < 0.01) in group C.
• The improvement rate of SH and PD in both groups A and C was obviously higher than that of group B (p < 0.05).