188Re-tin-colloid as a new therapeutic agent for rheumatoid arthritis.
Radiation synovectomy is a useful treatment modality in patients with refractory synovitis. We have developed a 188Re-tin-colloid as a new radiopharmaceutical agent and investigated its efficacy and safety in patients with rheumatoid arthritis. Radiation synovectomy was performed using 188Re-tin-colloid in 22 knees from 21 rheumatoid arthritis patients refractory to intra-articular corticosteroid injection. The efficacy and safety of administration of 370-1110 MBq of 188Re-tin-colloid were evaluated after 1, 3, 6, 9 and 12 months. Pain intensity on a visual analogue scale decreased significantly 12 months after therapy (mean+/-SD: 68.0+/-26.1 mm vs. 25.1+/-23.4 mm; P=0.0001 by the paired t-test). Pain decreased in 19 cases (86.3%), joint tenderness improved in 14 cases (63.6%) and joint swelling was reduced in all cases (100%). 188Re-tin-colloid was safe. The residual activity of 188Re in the blood was 0.077%+/-0.25% of the injected dose. The radioactivity of 188Re in the urine was 0.14%+/-0.13% of the injected dose. Transient reactive synovitis was observed in 18 cases (81.8%). No clinical side-effects or abnormalities in leucocyte count, platelet count, liver function tests or urine analysis were observed in any patient. In conclusion, in this first study of radiation synovectomy using 188Re-tin-colloid for patients with rheumatoid arthritis, the treatment resulted in the improvement of arthritis and was well tolerated.
Lee
E B
EB
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Shin
K C
KC
Lee
Y J
YJ
Lee
Y J
YJ
Cheon
G J
GJ
Jeong
J M
JM
Son
M W
MW
Song
Y W
YW
D001172:Arthritis, Rheumatoid / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000209:etiology; D007719:Knee Joint / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use*; D012211:Rhenium / Q000009:adverse effects / Q000627:therapeutic use*; D014001:Tin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
C481499:(188)Rhenium tin-colloid; D019275:Radiopharmaceuticals; D012211:Rhenium; D014001:Tin