Treatment of rheumatoid arthritis using radiopharmaceuticals.
One hundred and twenty one knees in 97 patients with seropositive rheumatoid arthritis and persistent knee synovitis were treated with the intra-articular injection of 270 mCi (30 GBq) of dysprosium-165 (165Dy) bound to ferric hydroxide macroaggregates. Of 81 knees evaluated at one year, 61% had good results, 23% had fair results and 16% had poor results. Of 44 knees evaluated at two years, 64% had good results, 16% had fair results and 20% had poor results. Knees with Stage I radiographic changes showed 72 and 81% good results at one and two years, respectively. Knees and Stage II radiographic changes showed 53 and 48% good results at one and two years, respectively. Leakage of radioactivity from the injected joint was minimal. Mean leakage to the venous blood was 0.15% of the injected dose. Mean leakage to the liver 24 h after injection was 0.64% of the injected dose. Mean leakage to the draining inguinal lymph nodes was 0.17% of the injected dose. These results indicate that 165Dy-ferric hydroxide macroaggregate is an effective agent for radiation synovectomy, particularly in knees with Stage I radiographic changes. The minimal leakage rates observed offer a definite advantage over previously used agents.
Zuckerman
J D
JD
Center for Arthritis Management, Hospital for Joint Diseases, New York, NY 10003.
Sledge
C B
CB
Shortkroff
S
S
Venkatesan
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000532:radiotherapy*; D004419:Dysprosium / Q000627:therapeutic use*; D005260:Female; D005290:Ferric Compounds / Q000627:therapeutic use*; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D013583:Synovial Membrane / Q000528:radiation effects
D005290:Ferric Compounds; D004419:Dysprosium; C021024:ferric hydroxide