Prevention of joint destruction in antigen-induced arthritis

In rheumatoid arthritis (RA) erosive joint changes are the dominating cause of chronic disability. In a cohort of patients with RA followed from early stages of the disease, we have observed a much larger prevalence of destructions in hips than in knee joints. The latter were frequently injected with triamcinolone hexacetonide in contrast to the former. In order to elucidate a possible role of local glucocorticoids we studied the antigen-induced arthritis model of Dumonde and Glynn in rabbits which, untreated, caused advanced joint destruction in 3/5 animals, whereas 0/14 animals receiving 3 injections of triamcinolone hexacetonide developed no such changes. The treatment was effective when started up to 2 weeks after induction of the arthritis. It is suggested that locally administered glucocorticoids may prevent or delay large joint destruction in RA.