Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that causes chronic synovial inflammation. Reactor-producedβ-particle emitting radionuclides is a new therapeutic strategy in the management of RA. This study was conducted in 2019and analyzed the toxicity and feasibility of 188Re-tin colloid injection, Three-Phase Positive Bone Scan, and Refractory KneePain. Ten patients with RA were administered radiosynovectomy with 188Re-tin colloid. The main complications after theintervention were assessed and compared with patients’ pre-intervention condition. Patients showed alleviation of pain,tenderness, and morning stiffness after the administration of radiosynovectomy. Only one RA patient received a corticosteroidinjection; the other 6 patients did not need a corticosteroid injection after radiosynovectomy. Intra-articular 188Re-tin colloidinjection seems to be an effective treatment modality for refractory knee joint pain in rheumatoid arthritis patients. Thus, it issuggested as a safe and effective strategy to apply.
Highlights
Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that causes chronic synovial inflammation and leads to articular cartilage destruction
Sleep disturbances before and after therapy were evaluated in the questionnaire using a ten-score scale, and patients' sleep characteristics were registered
This study reports that symptoms were alleviated in RA patients who experienced radiosynovectomy
Summary
Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that causes chronic synovial inflammation and leads to articular cartilage destruction. Selecting a suitable radionuclide for a specific therapeutic application is related to many factors, such as the half-life of the radiopharmaceutical, nature of particulate emission and energy, and concomitant γ-ray emission characteristics [3]. Several short-lived reactors that produce radionuclides have been introduced, such as 90Y, 188Re, 186Re, 153Sm, 166Ho and 105Rh, and 155Lu which is used for radionuclide therapies and seems to have more favorable features, especially considering the half-life, in comparison with 89Sr or 32P [4]. 188 Rhenium tin-colloid (188Re-tin) has been used for synovectomy in patients with chronic inflammatory knee joint pain refractory to conventional treatments and has achieved proper results [5]. The properties of 188Re enable the treatment of knee joint disease through its maximum tissue penetration of approximately 11 mm and its mean range of 3.8 mm [7]. The toxicity and feasibility of 188Re-tin colloid injection in the knees of patients with RA and refractory knee pain were analyzed
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