[The effect of intra-articular treatment with corticosteroids, polyvinylpyrrolidone and dimethyl sulfoxide on the composition of the synovial fluid in patients with rheumatoid arthritis].

Synovial fluid (SF) contained by the knee joint from 102 patients (80 with rheumatoid arthritis, 12 with osteoarthrosis, 10 with posttraumatic arthritis) and controls was studied for cytosis, activity of acid phosphatase, N-acetyl-beta-D-glucosaminidase, and cAMP and cGMP content. In 18% of the cases, the local corticosteroid treatment of patients with RA produced no beneficial effect. To treat RA and OA patients, dimethylsulfoxide (DMSO, 5 ml of 20% solution) and polyvinylpyrrolidone (PVP, 5 ml of 15% solution) were administered intra-articularly. In OA patients, injection of DMSO and PVP provided a good therapeutic effect. In RA patients, injection of DMSO produced a beneficial antiinflammatory action but it appeared short-term. The use of PVP in RA patients with pronounced local process enhanced synovitis symptoms, entailed an increase of the SF amount and cytosis, did not reduce the activity of lysosomal enzymes, and produced a negligible effect on the level of cyclic nucleotides. A mixture of DMSO (1 ml of 100% solution) and PVP (5 ml of 15% solution) applied to the treatment of RA patients exerted a favourable action on the local process in the joint, namely reduced all the parameters mirroring the intensity of inflammation.