Abstract
The use of low doses of radium-224 (224Ra) chloride for the treatment of ankylosing spondylitis was stopped following the discovery that patients treated with it had a higher than control incidence of leukaemia and other cancers. This was so even though the treatment resulted in decreased pain and increased mobility-both of which are associated with decreased mortality. It was decided to re-analyze the epidemiological data looking at all causes of death. The risk of leukaemia, solid cancer, death from non-cancer causes and from all causes in a study populations of men that received either the typical dose of 5.6 to 11.1 MBq of 224Ra, any dose of 224Ra or no radium were compared using the Cox proportional hazard model. For patients that received the typical dose of 224Ra agreed with the excess cancer was similar to that reported in previous studies. In contrast, these patients were less likely to die from non-cancer diseases and from all causes of death than the control patients. No excess mortality was also found in the population of all males that received the radionuclide. It is concluded that 224Ra treatment administered at low doses to patients with ankylosing spondylitis did not impact mortality from all causes. The study demonstrates the need to consider all causes of death and longevity when assessing health impacts following irradiation.
Highlights
Ankylosing spondylitis is a chronic, progressive inflammatory disease of the axial skeleton [1]
The results showed that 224Ra treatment at typical levels of 5.6MBq to 11.1MBq in total administered dose had no negative impact on the survival of the ankylosing spondylitis patients compared to the control patients
When all males treated with 224Ra were compared to controls no evidence of excess mortality was seen (HR = 1.01; 95% CI = 0.93–1.11; p = 0.74)
Summary
Ankylosing spondylitis is a chronic, progressive inflammatory disease of the axial skeleton [1]. The disease is associated with severe pain, decreased mobility and increased mortality [2]. Ankylosing spondylitis is treated palliatively to minimise pain and maximize mobility and from early in the twentieth century [3,4] until recently, some patients (in Germany in the 1910’s and again since the 1940’s, in France since 1922 and in the UK since 1946 [5]) were treated by the intravenous injection of radium-224 (224Ra, alpha-emitting radionuclide, T1⁄2 = 3.66 d) chloride solutions. Radium-224 Mortality projects/era/era_node.html The ERA contact person is Mandy Birschwilks The data recipient must not forward the data to any other group or person
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
