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 (> or =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.
journal_name
Joint Bone Spinejournal_title
Joint bone spineauthors
Singh JA,Mahowald MLdoi
10.1016/j.jbspin.2008.05.006subject
Has Abstractpub_date
2009-03-01 00:00:00pages
190-4issue
2eissn
1297-319Xissn
1778-7254pii
S1297-319X(08)00224-8journal_volume
76pub_type
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