Radioisotope synovectomy in the treatment of patients with rheumatoid arthritis
https://doi.org/10.14412/1996-7012-2019-1-101-107
Abstract
In a number of cases, systemic therapy for rheumatoid arthritis (RA), including disease-modifying anti-rheumatic drugs, biological agents, glucocorticoids (GCs), and nonsteroidal anti-inflammatory drugs, fails to completely suppress joint inflammatory changes in the patients. Therefore, local methods are widely used in the combination therapy of RA. Intra-articular injection of hyaluronic acid (HA) is a highly local treatment modality. HA can be used as initial therapy when it is necessary to achieve rapid clinical improvement, or at a later stage of the disease, in exacerbation of arthritis. However, in some patients the effect of intra-articular HA can be short-lasting, and a favorable result can be obtained with local radiotherapy. It is based on powerful irradiation of the inflamed synovium, which is provided by intra-articular injection of radioactive isotope colloids. In Russia, RA was successfully treated with colloidal Au-198, but its production was ceased in the 1990s, and agents for radioisotope synovectomy have been long unavailable.
Tungsten-188/Rhenium-188generator has been recently designed in Russia, which allows Rhenium-188 to be obtained in clinics. Preclinical trials have shown that intra-articular injection ensures good fixation of the drug in the knee joint with its insignificant accumulation in the liver and other non-target organs and tissues. Introduction of this drug into routine clinical practice can markedly improve the efficiency of treatment in patients with chronic arthritis.
About the Authors
R. M. Balabanova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Rimma Mikhailovna Balabanova
34A, Kashirskoe Shosse, Moscow 115522
Yu. A. Olyunin
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
A. M. Lila
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
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For citations:
Balabanova RM, Olyunin YA, Lila AM. Radioisotope synovectomy in the treatment of patients with rheumatoid arthritis. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2019;13(1):101-107. (In Russ.) https://doi.org/10.14412/1996-7012-2019-1-101-107
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