Rhenium-186 hydroxyethylidenediphosphonate (186Re HEDP) for the treatment of hemophilic arthropathy: first results.
OBJECTIVE
The aim of this study was to evaluate the efficacy of a systemic application of rhenium-186 hydroxyethylidenediphosphonate (Re HEDP) for pain treatment in patients with hemophilic arthropathies.


METHODS
Twelve patients with hemophilic arthropathy with at least 3 involved joints with persistent pain were included in this prospective study. A single dose of 15 mCi (555 MBq) Re HEDP was administered intravenously. Before and 12 weeks after treatment, pain assessment was performed using the visual analog scale (VAS). The pain status assessment included the general status, pain of all joints affected, and pain of the 3 mostly involved joints. Furthermore, quality of life was assessed.


RESULTS
With regard to the 3 most involved joints, an improvement of the pain symptoms in 25 of 36 (69.4%) joints was observed. With regard to all involved joints a median of 3 joints per patient improved after Re HEDP therapy. General pain status after treatment was 2.0 VAS points lower as compared with pretreatment. The total number of involved joints remained unchanged in 7 patients, increased in 1 patient, and decreased in the remaining 4 patients.


CONCLUSIONS
The results of this study show an improvement of the pain symptoms of the involved joints 12 weeks after therapy with Re HEDP in patients with hemophilic arthropathy. The only moderate success regarding a reduction of the total number of involved joints is by the fact that despite this improvement most affected joints remained still painful on a lower level after the therapy or due to newly affected joints not painful before initiation of the radionuclide therapy.
Bucerius
Jan
J
Department of Nuclear Medicine, University of Bonn, Bonn, Germany. jan.bucerius@ukb.uni-bonn.de
Wallny
Thomas
T
Brackmann
Hans-Hermann
HH
Joe
Alexius Y
AY
Roedel
Roland
R
Biersack
Hans-Jürgen
HJ
Palmedo
Holger
H
D000328:Adult; D018771:Arthralgia / Q000209:etiology / Q000532:radiotherapy*; D001177:Arthropathy, Neurogenic / Q000209:etiology / Q000532:radiotherapy*; D012968:Etidronic Acid / Q000627:therapeutic use*; D006395:Hemarthrosis / Q000209:etiology / Q000532:radiotherapy*; D006467:Hemophilia A / Q000150:complications / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010147:Pain Measurement / Q000528:radiation effects*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D016896:Treatment Outcome
D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C101598:rhenium-186 HEDP; D012968:Etidronic Acid