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Certolizumab pegol was effective for treating residual synovitis after total knee arthroplasty in a patient with rheumatoid arthritis: therapeutic monitoring by ultrasound

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Abstract

We present the case of a 59-year-old female who developed rheumatoid arthritis in 2007. Right total knee arthroplasty (TKA) was performed in 2008. Although she was treated with methotrexate (MTX) after the operation, this treatment was insufficient. Infliximab (IFX) was introduced in 2001, and she achieved clinical remission. Left TKA was performed in October 2014. Because active synovitis was not detected by ultrasound after the operation, IFX was discontinued. She had been treated with MTX 8 mg weekly. However, arthralgia of the bilateral knees developed in March 2015. Ultrasound showed synovial hypertrophy with vascular signals representing postoperative residual synovitis. She was given certolizumab pegol. According to ultrasound, the synovitis had improved after 3 months.

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Abbreviations

ADA:

Adalimumab

CT:

Computed tomography

CZP:

Certolizumab pegol

DAS:

Disease activity score

ESR:

Erythrocyte sedimentation rate

IFX:

Infliximab

TKA:

Total knee arthroplasty

MRI:

Magnetic resonance imaging

MTX:

Methotrexate

PSL:

Prednisolone

RA:

Rheumatoid arthritis

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Authors and Affiliations

  1. Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan

    Shin-ya Kawashiri

  2. Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Shin-ya Kawashiri & Atsushi Kawakami

  3. Department of Rheumatology, NHO Nagasaki Medical Center, Omura, Japan

    Tohru Michitsuji

Authors
  1. Shin-ya Kawashiri
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  2. Tohru Michitsuji
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  3. Atsushi Kawakami
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Corresponding author

Correspondence to Shin-ya Kawashiri.

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Ethical statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from the patient for this report.

Conflict of interest

The authors have no conflicts of interest to report.

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Kawashiri, Sy., Michitsuji, T. & Kawakami, A. Certolizumab pegol was effective for treating residual synovitis after total knee arthroplasty in a patient with rheumatoid arthritis: therapeutic monitoring by ultrasound. J Med Ultrasonics 45, 371–374 (2018). https://doi.org/10.1007/s10396-017-0806-5

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  • DOI: https://doi.org/10.1007/s10396-017-0806-5

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