Efficacy of Methylprednisolone pulse therapy versus Infliximab in the treatment of severe flares of chronic polyarthritis

Background: To compare short term efficacy of pulse intravenous (iv) Methylprednisolone (MP) versus Infiximab in flares of polyarthritis. Patients-methods: Observational study of consecutive patients admitted with flares of chronic polyarthritis. Treatment consisted of three iv doses of MP 1000 mg on alternate days (MP-group, n=10) or of Infliximab will be 3 mg/kg at baseline, two, and six weeks later (I-group, n=9). DMARD therapy was initiated/continued in all patients. Disease parameters at baseline (t = 0), two weeks (t = 1) and twelve weeks (t = 2) were compared by non-parametric testing. Results: Reductions in disease parameters at both t=1 and t=2, the occurrence of side effects and the proportion of patients reaching ACR 20, 50 or 70% response criteria were similar in both groups. Conclusion: Pulse MP resulted in a symptomatic response similar to Infliximab in our patients. The benefit of MP was observed for up to 3 months.