Intra‐Articular Thiotepa in Rheumatoid Disease. A Clinical Analysis of 123 Injected MP and PIP Joints

Abstract

This report deals with 30 patients with established rheumatoid disease who received an intra-articular injection of Thiotepa into the small joints of the hands. One hundred twenty-three individual joints have been injected, and the follow-up period averages 4.8 years. The study represents a follow-up report on an original trial begun in 1962 by Dr. Adrian E. Flatt at the University of Iowa Hospitals. Our results are assessed on the basis of four parameters: symptomatic pain relief, clinical response to injection, postinjection radiographic progression, and postinjection progression of clinical deformity. An attempt i s made to relate the results to the stage of local disease in the injected joints, as well as t o the systemic disease state in each individual. Only 7 of our 30 patients had a good result when all four parameters were considered. Our analysis of these 7 patients, and our indications for the continued use of Thiotepa are included in this report.