Background: Among rheumatoid arthritis patients (RA), general disease activity is well
regulated by disease-modifying anti-rheumatic medications (DMARDS), but sometimes local inflammation
still persists among a few joints. Adjuvant modern molecular interventions as Platelet
Rich Plasma (PRP) with a suggested down regulating effect on inflammatory mediators has a
proven effect in the management of RA.
We aim to evaluate the therapeutic effect of intra-articular PRP versus steroid in RA patients and
their impact on inflammatory cytokines IL1B, TNF α, local joint inflammation, disease activity
and quality of life (QL).
Methods: Open-labeled parallel randomized control clinical trial was carried out on 60 RA patients
randomly divided into 2 groups, Group 1: included 30 patients received 3 intra-articular injections
of PRP at a monthly interval, Group 2: included 30 patients received single intra-articular injection
of steroid. They were subjected to clinical, laboratory, serum IL1B and TNF α assessment at baseline
and at 3, and 6 months post injection.
Results: Patients of both groups showed improvements in their scores of evaluating tools at
3months post injection and this improvement was persistent in the PRP group up to 6 months post
injection while it was continued only for 3 months in the steroid group.
Conclusion: PRP is a safe, effective and useful therapy in treating RA patients who had an insufficient
response and persistent pain and inflammation in just one or two joints through its down regulating
effect on inflammatory cytokines IL1B, TNF α with subsequent improvement of local joint
inflammation, disease activity and QL.