The efficacy of dexamethasone iontophoresis for the treatment of rheumatoid arthritic knees: A pilot study

Abstract

Objective. To examine the efficacy of dexamethasone sodium phosphate (DEX) iontophoresis for the treatment of rheumatoid arthritis (RA) of the knee, and to obtain statistical information for a future randomized controlled trial (RCT). Methods. Ten subjects with RA, ranging in age from 34–75, were randomly assigned to either the experimental or placebo group. Iontophoresis treatments were given to both groups on days 1, 3, and 5. Five subjects in the experimental group received a mixture of 1 ml of DEX (4 mg/ml) and 1 ml of injectable sterile water; those in the placebo group received 2 ml of saline solution. Pain on movement, at rest, and on pressure, active joint count, and active range of motion, were evaluated on days 1, 5, and 20. The patient's global assessment of treatment efficacy was also assessed on days 5 and 20. Mann‐Whitney U tests and Friedman two‐way analyses of variance were performed for statistical analyses. Results. Pain at rest was found to be statistically different between the two groups (P = 0.0317). Statistical significance was also found over time for pain on movement within the experimental group (P = 0.0224). Conclusion. The results suggest that DEX iontophoresis is more effective than placebo in relieving pain at rest and on movement in the RA knee. Based on the study data, a total of 40 subjects will be required for an RCT of a similar nature.

Anti-inflammatory Effects of Low Intensity Laser Therapy on Adjuvant-induced Rheumatoid Arthritis in Rat

“…Treatment modalities of RA include analgesic drugs, non-steroidal anti-inflammatory drugs, physical therapy, electrotherapy, steroid injections, ultrasound, iontophoresis, and low intensity laser therapy [13][14][15] . Low intensity laser therapy has many benefits, such as microcirculation enhancement, vasodilatation, tissue metabolism improvement, activation of angiogenesis, nerve regeneration, and analgesic effects at the tissue level [16][17][18] .…”

Comparison of the Therapeutic Efficacy of Diclofenac Sodium and Methyl Salicylate Phonophoresis in the Management of Knee Osteoarthritis

“…[12] Phonophoresis (PH) is a technique that employs the use of ultrasound waves to enhance percutaneous absorption of drug delivery similar to iontophoresis. [11,13] Phonophoresis was first used to treat polyarthritis of the hand by delivery of hydrocortisone ointment into inflamed areas in 1954. [14] Since then it has been reported to be used in the treatment of various dermatological and musculoskeletal disorders.…”

“…[14] Since then it has been reported to be used in the treatment of various dermatological and musculoskeletal disorders. [13][14][15][16] Previous studies have established the therapeutic effectiveness of various types of NSAIDs gel PH on both acute and chronic musculoskeletal pain and disorders. [17][18][19][20] Because of the established efficacy of this modality, there are several ongoing studies with some controversies from previous studies.…”

Effectiveness of dexamethasone iontophoresis for temporomandibular joint involvement in juvenile idiopathic arthritis

“…Despite the lack of its use for JIA‐associated TMJ involvement, DIP has been employed for the treatment of arthritis in the past. In an earlier pilot study, adult patients with rheumatoid arthritis experienced a reduction in knee pain with DIP to the knee joints (16). Likewise, Ozgocmen et al showed that triamcinolone iontophoresis resulted in a reduction in synovial tissue vascularity on power Doppler sonography, a surrogate for reduced inflammation (18).…”

“…Low‐grade electric currents lead to the dissociation of hydrophilic medications into ions that move to penetrate deeper anatomic structures (15). DIP therapy has been utilized for more than 30 years to treat various musculoskeletal conditions, including tendinitis, epicondylitis, enthesitis, and inflammatory peripheral arthritis (16–19). Given the relatively superficial position of the TMJ, we hypothesized that DIP is beneficial for the treatment of the TMJ of children with JIA.…”