Abstract
We report the use of intra-articular Botulinum toxin A in two RA patients with persistently painful monoarthritis in ankle/feet joints. Both patients had monarticular pain despite a good response of all other joints to a combination therapy that included anti-tumor necrosis factor therapy. Both patients had failed intra-articular corticosteroid injections and declined surgical options. After a single, "off-label", intra-articular injection of Botulinum toxin A into the right ankle (100 unit) and left first metatarsophalangeal joint (25 unit), respectively, pain and function improved significantly (≥40%) in both patients. Durable response with improvement of pain and function lasting 15-18 months was noted (follow-up continuing). Ankle joint swelling resolved by 15 months and MTP joint swelling by one month. Intra-articular BoNT/A may be an additional therapeutic option in RA patients with persistent monoarthritis. A randomized study is underway to confirm these findings.
Original language | English (US) |
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Pages (from-to) | 190-194 |
Number of pages | 5 |
Journal | Joint Bone Spine |
Volume | 76 |
Issue number | 2 |
DOIs | |
State | Published - Mar 1 2009 |
Keywords
- Botulinum toxin
- Intra-articular injection
- Refractory joint pain
- Rheumatoid arthritis