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eISSN: 2084-9834
ISSN: 0034-6233
Reumatologia/Rheumatology
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5/2021
vol. 59
 
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abstract:
Case-based review

Is intra-articular infliximab therapy a good alternative to radionuclide synovectomy for a patient with refractory pigmented villonodular synovitis?

Anna Felis-Giemza
1
,
Anna Apanel-Kotarska
1
,
Marek Chojnowski
1
,
Marzena Olesińska
1

1.
Department of Systemic Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
Reumatologia 2021; 59, 5: 340–345
Online publish date: 2021/11/07
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Pigmented villonodular synovitis (PVNS) is a rare disease that has clinical and histopathological characteristics of both benign proliferative disorder and a chronic inflammatory process of the synovial tissue. The primary mode of treatment is surgery followed by an adjuvant radiotherapy; however, the risk of recurrence is a significant (40–70%). Several publications suggest that the TNF-α inhibitors might be a treatment option. We present a case of a 29-year-old female diagnosed with PVNS of the knee joint, refractory to surgery and 3 radionuclide synovectomies. Because the possibilities of conventional therapy were exhausted, treatment with an intra-articular anti-TNF-α monoclonal antibody (infliximab) was performed. Despite a high safety profile and a good tolerance of that therapy we did not observe significant clinical and radiological improvement. To assess the effectiveness of intra-articular TNF-α inhibitors as an adjuvant treatment in PVNS, prospective studies are needed.
keywords:

pigmented villonodular synovitis, TNF- inhibitor, intra-articular therapy







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