Influence of intraarticular corticosteroid administration on serum cytokines in rheumatoid arthritis.

Though the efficacy of intraarticular (IA) corticosteroid administration in the therapeutic management of rheumatoid arthritis (RA) has been well documented, its immunomodulatory effects have not been defined. Categorization of these effects is important to develop safe derivative therapeutic strategies with a more targeted mechanism of action as they relate to the pathophysiology of RA. We describe here a broad spectrum immune response to inflammation as evidenced by rapid transient systemic inhibitory effects on key inflammatory regulators induced by the effects of IA administration of triamcinolone acetonide in a case of active RA who failed to respond to methotrexate.