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

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 is made to relate the results to the stage of local disease in the injected joints, as well as to 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.