Efficacy of joint cavity injection with recombinant human type II tumor necrosis factor receptor antibody fusion protein for rheumatoid arthritis combined with knee arthritis

Abstract

Purpose: To investigate the clinical efficacy of injection of recombinant human type II tumor necrosis factor receptor antibody fusion protein (rhTNFR:Fc) into the joint cavity for the treatment of rheumatoid arthritis with knee arthritis. Methods: Fifty-eight patients with rheumatoid arthritis and knee arthritis were selected as outpatients and inpatients in our hospital and randomly divided into a treatment group and a control group of 29 patients each. The treatment group received a single intra-articular injection of recombinant human type II tumor necrosis factor receptor-antibody fusion protein; the control group received a subcutaneous injection of the same drug at the same dose each time. In the control group, the same drug was injected subcutaneously each time. 50 mg of the drug was administered weekly to all patients, and the target knee joint fluid was aspirated by arthrocentesis before each injection; 2 mL of joint fluid was retained before the first and fifth injections (i.e., 2 weeks after treatment); the clinical parameters of the two groups before and 2 weeks after treatment were compared. (ii) Measurement of the content of the joint fluid matrix metalloproteinase-3 (MMP-3) in patients before and 2 weeks after treatment (iii) Follow-up of patients in both groups after treatment, and the WOMAC scores before and after treatment were collated, and the collected data were collated and processed by SPSS26.0 software. Results: the ESR, CRP, PLT, synovial thickness and depth of fluid in both groups decreased, and the synovial thickness and depth of fluid in the treatment group were lower than that in the control group, the difference was statistically significant (P < 0.05) (see Table 1); 2. ; 0.05) (see Table 2).3. The WOMAC classification showed that both groups improved their pain symptoms after treatment, and the treatment group was superior to the control group, the difference was statistically significant (P < 0.05) (see Table 3). Conclusion: Injection of recombinant human type II tumor necrosis factor receptor antibody fusion protein intra-articular administration of TNF-α binds to TNF-α in the synovial fluid and synovial tissues of the knee joint, blocks the inflammatory waterfall response, controls synovial inflammation, relieves patients' pain, and avoids the adverse effects of systemic application. Therefore, intra-articular injection of TNF-α antagonist for RA is a safe and effective treatment, especially for patients with concomitant knee arthritis can be the treatment of choice.Table 1Comparison of pre- and post-treatment clinical observations between the two groups (n=29, ‾x±s)GroupingTimeESR (mm/h)CRP (mg/L)PLT (×109 /L )Synovial thickness (mm)Liquid depth (mm)treatment grouppre-treatment84.35±29.59105.79 ± 59.51416.04±78.566.37±3.927.87 ± 2.59post-treatment33.97±12.8725.75 ± 16.49361.05 ± 65.153.19 ± 1.543.28±1.26control grouppre-treatment79.02±19.34115.58 ± 57.15430.04±64.166.48±3.257.96±3.58post-treatment41.01±16.4534.54±24.07378.07±58.604.92±1.875.76 ± 2.04 Open table in a new tab Table 2Comparison of joint fluid MMP-3 levels before and after treatment in the two groups (n=29, x±s, pg/mL)GroupingPre-treatmentPost-treatmenttreatment group95.24±14.4533.87 ± 4.59control group94.83 ± 13.7646.15±4.12 Open table in a new tab Table 3Comparison of WOMAC scores before and after treatment in the control and treatment groupsgroupingpre-treatmentpost-treatmenttreatment group16.32 ± 2.455.82 ± 1.45control group16.48 ± 2.249.18±1.78 Open table in a new tab