188RE-TIN-COLLOID AS A NEW THERAPEUTIC AGENT OF RA

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From the ACR: 188RE-TIN-COLLOID AS A NEW THERAPEUTIC AGENT OF RHEUMATOID

ARTHRITIS.

Eun Bong Lee, Ki Chul Shin, Yun Jong Lee, Young Joo Choi, Yong Jin Lee,

Gi Jeong Cheon, Jae Min Jeong, Mi Won Son, Yeong Wook Song Seoul, Korea

Radiation synovectomy is one of the useful treatment modalities in

patients with refractory synovitis because of convenience, long term

effect, repeatability and avoidance of surgery. Various

radiopharmaceuticals including 90Yttrium, 165Dysprosium, 169Erbium are

being widely used in European countries. 188Re from 186/188Re generator

is an ideal radiopharmaceutical agent because beta ray (2.1 MeV) from

188Re is appropriate for synovial cell ablation and gamma ray (155 KeV)

is ideal for dosimetry. Ideal particle size (2-3 mm) was achieved by

conjugation with tin-colloid.

After confirming the safety and efficacy of 188Re-tin-colloid in anmal

models, we performed radiation synovectomy in 18 knees from 17

rheumatoid arthritis patients who were refractory to local

corticosteroid injection. After the injection of 10-30 mCi of 188Re-tin

colloid, the efficacy and safety was evaluated at 1, 3, 6, 9, 12th

months.

Pain in visual analog scale improved in 15 cases (83%), joint tenderness

in 12 cases (67%), swelling in 16 cases (89%) and range of motion in 14

cases (78%). No clinically significant leakage was found and blood

activity of 188Re was 0.009%/injection-dose. Reactive synovitis was

observed in 16 patients (89%), however it was mild and disappeared

spontaneously within 3 days. Abnormalities in peripheral blood

leukocytes, platelets, liver function tests and urine analysis were not

found in any patients.

In conclusion, 188Re-tin-colloid is a strong candidate agent for

radiation synovectomy with its superior efficacy and safety.

Session Info. : Poster Session: RA Therapy-Novel Treatments (7:30

AM-9:00 AM) Board Number: 53