Our aim was to evaluate the effectiveness of tumour
necrosis factor (
TNF) inhibitors as add-on
therapy for knee
synovitis that did not respond to
disease-modifying antirheumatic drugs (DMARDs) and other standard treatments in patients with peripheral spondyloarthritis (SpA). We retrospectively studied 27 SpA patients, in whom an anti-TNF agent was added for active peripheral
arthritis with knee
synovitis refractory to DMARDs and treatment with low-dose oral
corticosteroids and/or nonsteroidal anti-inflammatory drugs (
NSAIDs) and intra-articular (IA)
corticosteroids. As response of knee
synovitis, were considered the absence of swelling, tenderness, and decreased range of movement in the clinical examination, after 4 months of anti-TNF
therapy. In twenty-four (88.9%) of the patients there was response of knee
synovitis. No statistical differences in gender (P = 0.53), age (P = 0.88), disease subtype (P = 0.22), and pattern of
arthritis (P = 0.20) between knee
synovitis responders and nonresponders were found. Fourteen patients managed to stop
DMARD therapy and six, all of whom were initially on DMARDs combination, to decrease the number of DMARDs to one, maintaining simultaneously the response of knee
synovitis. Our results imply a beneficial effect of adjunctive anti-TNF
therapy on knee
synovitis not responding to DMARDs and other standard treatments in patients with peripheral SpA.