Abstract:
STUDY DESIGN:Randomized, controlled study. OBJECTIVE:To evaluate the effect of infliximab on herniated nucleus pulposus (HNP) resorption. SUMMARY OF BACKGROUND DATA:Although the effects of tumor necrosis factor alpha (TNF-alpha) on HNP resorption are not fully understood, TNF-alpha appears to be an essential mediator in HNP resorption. METHODS:As part of a substudy of the FIRST II study, magnetic resonance images (MRIs) were obtained from 21 patients who were candidates for discectomy at weeks 0, 2, 12, and 26 after receiving a single infusion of either 5 mg/kg infliximab (11 patients) or placebo (10 patients). The volume (mm3) of HNP, thickness (mm) and extent (%) of rim enhancement, and presence of nerve root edema were assessed. RESULTS:HNP volume decreased significantly from baseline to 6 months in both treatment groups (P < 0.01), with no difference noted between the infliximab and placebo groups. By week 2, rim enhancement thickness increased significantly in the infliximab group compared with the placebo group (P = 0.003). Two patients in each group required back surgery before the 6-month assessment. CONCLUSIONS:Infliximab did not appear to interfere with disc herniation resorption over a 6-month period.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Autio RA,Karppinen J,Niinimäki J,Ojala R,Veeger N,Korhonen T,Hurri H,Tervonen Odoi
10.1097/01.brs.0000244616.64962.9esubject
Has Abstractpub_date
2006-11-01 00:00:00pages
2641-5issue
23eissn
0362-2436issn
1528-1159pii
00007632-200611010-00002journal_volume
31pub_type
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