Clinical outcome after one year following samarium-153 particulate hydroxyapatite radiation synovectomy.
The clinical outcome and tolerability following treatment with samarium-153 particulate hydroxyapatite was evaluated in patients with persistent rheumatoid knee synovitis. The clinical review of 18 patients treated with intra-articular samarium-153 particulate hydroxyapatite combined with triamcinolone hexacetonide who had failed to obtain more than 4 weeks symptom relief from a prior intra-articular glucocorticoid injection was undertaken. No unwanted effects from the treatment were observed. Symptom relief was maintained in 56% patients at 6 months and in 44% of patients at 12 months following treatment. Median duration of symptom relief was 9 months. There was a significantly higher mean baseline Ritchie Articular Index in patients relapsing within 3 months and a trend towards earlier relapse in patients with higher indices of disease activity at the time of treatment. There was a trend towards earlier relapse in patients with a poor range of knee flexion at baseline and with worse indices of intra-articular radiopharmaceutical distribution. Samarium-153 particulate hydroxyapatite knee synovectomy is well tolerated and may be an effective treatment for carefully selected patients with persistent rheumatoid knee synovitis.
Clunie
G
G
Department of Medicine, University College London, UK.
Lui
D
D
Cullum
I
I
Ell
P J
PJ
Edwards
J C
JC
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006882:Hydroxyapatites / Q000008:administration & dosage / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D012493:Samarium / Q000008:administration & dosage / Q000627:therapeutic use*; D013585:Synovitis / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D006882:Hydroxyapatites; D011868:Radioisotopes; C091049:samarium hydroxyapatite; D012493:Samarium