Evaluation of Intra-articular Colloidal Gold Au 198 in the Treatment of Persistent Knee Effusions

Ansell, Barbara M.; Crook, Anne C.; Mallard, J. R.; Bywaters, E. G. L.

doi:10.1136/ard.22.6.435

Cited by 143 publications

(53 citation statements)

References 3 publications

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“…Admittedly, these parameters are difficult to quantify. However, they have been used frequently in other studies reporting on the efficacy of both surgical and radiation synovectomy (4)(5)(6)(7)11,12,17) and thereby provide a reasonable basis for comparison of results.…”

Section: Discussionmentioning

confidence: 99%

Treatment of rheumatoid synovitis of the knee with intraarticular injection of dysprosium 165‐ferric hydroxide macroaggregates

Sledge

Zuckerman

Zalutsky

et al. 1986

Arthritis & Rheumatism

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One hundred eight knees of 93 patients with seropositive rheumatoid arthritis and persistent synovitis of the knee were treated with an intraarticular injection of 270 mCi of dysprosium 165 bound to ferric hydroxide macroaggregate. Leakage of radioactivity from the injected joint was minimal. Mean leakage to the venous blood 3 hours after injection was 0.11% of the injected dose; this corresponds to a mean whole body dose of 0.2 rads. Mean leakage to the liver 24 hours after injection was 0.64% of the injected dose; this corresponds to a mean liver dose of 3.2 rads. In 7 additional patients examined, there was negligible or near negligible activity found in the draining inguinal lymph nodes. One-year followup was possible for 74 knees (63 patients). Sixty-one percent of the knees had good results, 23% had fair results, and 16% had poor results.There was a direct correlation between the radiographic Submitted for publication January 14, 1985; accepted in revised form June 24, 1985. stage and response to treatment. In knees with stage I radiographic changes, 72% showed good results; 93% showed improvement. In knees with stage I1 changes, 59% showed good results; 81% showed improvement. These preliminary results indicate that dysprosium 165-ferric hydroxide macroaggregate is an effective agent for radiation synovectomy. The low leakage rates observed offer a definite advantage over agents previously used.

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Section: Discussionmentioning

confidence: 99%

Treatment of rheumatoid synovitis of the knee with intraarticular injection of dysprosium 165‐ferric hydroxide macroaggregates

Sledge

Zuckerman

Zalutsky

et al. 1986

Arthritis & Rheumatism

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“…The British experience with regional irradiation for ankylosing spondylitis involved more than 14,000 patients treated with a minimum of 900 to 2,000 rads (3)(4)(5).…”

Section: Discussionmentioning

confidence: 99%

“…Local irradiation of pigmented villonodular synovitis and intraarticular injection of radionuclides have met with some success as alternatives to surgical synovectomy (3)(4)(5). We investigated how local irradiation of inflamed joints would compare to TLI in suppressing inflammatory arthiritis in an animal model.…”

Section: Total Lymphoid and Local Joint Irradiation In The Treatment mentioning

confidence: 99%

Total lymphoid and local joint irradiation in the treatment of adjuvant arthritis

Schurman

Hirshman

Strober

1981

Arthritis & Rheumatism

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Total lymphoid irradiation (TLI) with 3,400 rads delivered in 17 divided doses, 600 rads at local paw irradiation in 3 divided doses, or both TLI and local irradiation were used to treat Lewis rats with adjuvant arthritis. Either TLI alone or local paw irradiation modestly reduced the severity of arthritis compared to a control group (P < 0.05). TLI treated animals had more initial suppression of inflammation. Adjuvant rats treated with a combination of both TLI and local paw irradiation had a profound and long lasting reduction in inflammation and permanent arthritis (P < 0.001).Immunosuppression in one form or another is well known to be beneficial in the treatment of inflammatory polyarthropathies. The lymphocyte is integrally involved in the histopathology of all forms of inflammatory arthritis in humans and animals. Alkylating agents which are known to destroy lymphocytes and thoracic duct drainage which mechanically depletes lymphocytes are associated with a decrease in synovitis in patients with rheumatoid arthritis (1). We reasoned, therefore, that the technique of selective irradiation (TLI) used to treat Hodgkin's disease might prove to be a valuable treatment for inflammatory synovitis since this regimen produces long lasting immunosuppression and T lymphocytopenia (2). Local irradiation of pigmented villonodular synovitis and intraarticular injection of radionuclides have met with some success as alternatives to surgical synovectomy (3-5). We investigated how local irradiation of inflamed joints would compare to TLI in suppressing inflammatory arthiritis in an animal model. This report describes the results of TLI and local joint irradiation separately and in combination in adjuvant arthritis of rats. It was found that either TLI or local joint irradiation is therapeutic by itself, but the combination of both modalities is substantially more effective than either alone. MATERIALS AND METHODSExperimental scheme. Adult inbred Lewis rats weighing 350 to 500 gm were injected with 1.0 mg of Mycobacterium butyricum suspended in medium grade oil at a concentration of 10 mg/ml in the subcutaneous aspect of the left hind paw (LHP), in a procedure similar to that reported by Chang (6). On the seventeenth day after inoculation of the LHP, animals that developed arthritis in one or more of the remaining three paws and had a minimum arthritis rating score of three (see "Scoring of joints") were divided into four groups of approximately 4 animals each. Groups were chosen so that there was a similar distribution of arthritis, and the average score of each group was similar at the start. All treatment regimens started on the seventeenth day after adjuvant inoculation. One group served as controls and received no irradiation. A second group was given a total of 3,400 rads of TLI in divided doses of 200 rads/day on a 5-day-a-week basis over a period of 24 days. A third group of animals received both 3,400 rads of TLI and 600 rads to each of the four paws. The paws were irradiated with 200 rads/day for 3 days starting ...

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“…In animals killed 3 and 6 months after treatment there were only minimal differences between the treated and untreated knees, indicating that the antiinflammatory effects on synovial tissue and articular cartilage preservation were not sustained. Key Words: Radiation synovectomyDysprosium-165-ferric hydroxide macroaggregates.Radiation synovectomy using beta-emitting radioisotopes such as yttrium-90 (%Y) and gold-198 (198A~) has been shown to be effective in the treatment of rheumatoid synovitis of the knee (1,6,7,9,11). Since 1975, dysprosium-165 ('65Dy) labeled to ferric hydroxide macroaggregates (FHMA) has been studied as an agent of radiation synovectomy.…”

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confidence: 99%

Treatment of antigen‐induced arthritis in rabbits with dysprosium‐165–ferric hydroxide macroaggregates

Zuckerman

Sledge

Shortkroff

et al. 1989

Journal Orthopaedic Research

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Dysprosium-165-ferric hydroxide macroaggregates (165Dy-FHMA) was used as an agent of radiation synovectomy in an antigen-induced arthritis model in New Zealand white rabbits. Animals were killed up to 6 months after treatment. 165Dy-FHMA was found to have a potent but temporary antiinflammatory effect on synovium for up to 3 months after treatment. Treated knees also showed significant preservation of articular cartilage architecture and proteoglycan content compared with untreated controls, but only during the first 3 months after treatment. In animals killed 3 and 6 months after treatment there were only minimal differences between the treated and untreated knees, indicating that the antiinflammatory effects on synovial tissue and articular cartilage preservation were not sustained.

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Evaluation of Intra-articular Colloidal Gold Au 198 in the Treatment of Persistent Knee Effusions

Cited by 143 publications

References 3 publications

Treatment of rheumatoid synovitis of the knee with intraarticular injection of dysprosium 165‐ferric hydroxide macroaggregates

Treatment of rheumatoid synovitis of the knee with intraarticular injection of dysprosium 165‐ferric hydroxide macroaggregates

Total lymphoid and local joint irradiation in the treatment of adjuvant arthritis

Treatment of antigen‐induced arthritis in rabbits with dysprosium‐165–ferric hydroxide macroaggregates

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