Serum levels of sex steroid hormones and matrix metalloproteinases after intra-articular glucocorticoid treatment in female patients with rheumatoid arthritis

• OBJECTIVES: To study metalloproteinase activity and sex steroid hormone production in serum after intra-articular glucocorticoid treatment for knee synovitis. METHODS: A total of 18 female patients with rheumatoid arthritis (RA) and synovitis of the knee with need for intra-articular glucocorticoid treatment were included in this study. Serum samples of matrix metalloproteinases (MMP-1/TIMP complex and MMP-3), dehydroepiandrosterone sulphate (DHEAS), testosterone, estradiol, steroid hormone binding globulin (SHBG), follicle stimulating hormone (FSH) and luteinizing hormone(LH) were collected before injection with 20 mg triamcinolone hexacetonide, and 24 hours, 48 hours, one week and two weeks after injection, respectively. RESULTS: Serum levels of MMP-3 were significantly decreased, but MMP-1/TIMP complex was unaffected. DHEAS, testosterone and estradiol levels all decreased and tended to return to baseline levels during the observation period. SHBG, FSH and LH levels were unchanged. CONCLUSION: Intra-articular glucocorticoid treatment causes a temporary, but considerable suppression of sex steroid hormone secretion. The reduction of MMP-3 indicates an inhibition of the inflammatory, but probably also the cartilage destructive processes within the treated joint.

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