Effects of Radiosynovectomy with P-32 Colloid Therapy in Hemophilia and Rheumatoid Arthritis

Abstract

Radiosynovectomy in RA showed a 3-month pain palliative effect. One intra-articular knee radiosynoviorthesis in haemophilic patients provides a more than 3- month relief of symptoms after treatment with locally produced P-32 (11 patients). This turned out to be a safe, economic alternative procedure in emerging nations where the availability of AHF is difficult and expensive.

Radiosynovectomy using yttrium-90, phosphorus-32 or rhenium-188 radiocolloids versus corticoid instillation for rheumatoid arthritis of the knee

“…Several candidates have been proposed to replace commercially available radiocolloid formulations of yttrium-90, rhenium-186 and erbium-169. These formulations include phosphorus-32 colloid [9,10], rhenium-186 sulphide [11], samarium-153 conjugated to particulate hydroxyapatite [12,13], dysprosium-165 ferric hydroxide [14,15], holmium-166 boromacroaggregates [16,17], ytterbium-175 and lutetium-177 hydroxyapatite [18,19]. In this study, the therapeutic efficacy of yttrium-90 citrate was compared to that of phosphorus-32 and rhenium-188 colloids.…”

32P colloid radiosynovectomy in treatment of chronic haemophilic synovitis: Iran experience

“…In addition, this procedure can be repeated in case of primary or secondary failure or relapse [5,20]. 32 P is considered as an appropriate radioisotope choice for radiosynovectomy [17]. It has a 14-day half-life that causes a more steady release of energy, which lessens the potential for acute inflammatory response [11].…”

“…Since then, multiple radioisotopes have been used for synoviorthesis purpose in haemophilic patients with promising results [9][10][11][12][13][14][15]. 32 P is an alternative radioisotope, and its use has been approved by the Federal Drug Agency [16]. Experiences with implementation of 32 P have also proved its efficacy in reducing haemarthrosis occurrence [17][18][19][20][21][22], improving joint function [22] and quality of life [17,21].…”

Opinions on radiosynovectomy for chronic haemophilic synovitis: point/counterpoint

“…Of 125 radiosynovectomies in 81 patients, Siegel and colleagues reported that 54% of patients experienced complete cessation of bleeding into the treated joint and 73% had improved mobility of the treated joint [20]. Soroa and colleagues reported that the procedure reduced bleeding and pain and increased ROM in the treated joints of 21 of 26 (80%) patients [43]. Similar reductions in the frequency of joint bleeding and improvements in joint mobility have been described for PWH undergoing radiosynovectomy with Y-90 [25,26,44,45] and Re-186 [23,26,44].…”