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© 1994 British Society for Rheumatology

research-article

A COMPARATIVE STUDY OF THE SAFETY AND EFFICACY OF DYSPROSIUM-165 HYDROXIDE MACRO-AGGREGATE AND YTTRIUM-90 SILICATE COLLOID IN RADIATION SYNOVECTOMY—A MULTICENTRE DOUBLE BLIND CLINICAL TRIAL

J. EDMONDS, R. SMART, R. LAURENT, P. BUTLER, P. BROOKS, R. HOSCHI, J. WISEMAN, S. GEORGE, F. LOVEGROVE, A. WARWICK, E. OWEN, J. WEBB, R. BOOTH, L. CLEMENS, A. McLAREN, M. DRUCE, E. HETHERINGTON, S. PROSSER, J. WHITWELL and R. LAMBRECHT

The Australian Dysprosium Trial Group: Australian Nuclear Science and Technology Organisation

Correspondence to: Correspondence to: J. Edmonds Department of Rheumatology St. George Hospital Gray Street Kogarah NSW 2217 Australia.

The aim of our study was to compare the safety and efficacy of a new preparation, Dysprosium-165 Hydroxide Macro-aggregate (165Dy) with Yttrium-90 Silicate (90Y) for radiation synovectomy of the knee in patients with RA and OA. A multicentre double blind clinical trial with subjects randomized to receive 165Dy or 90Y was undertaken in Sydney, Melbourne and Perth. Seventy knees of 59 patients were studied, using as clinical end point measurements pain in the knee on walking, pain in the knee at rest and stiffness in the knee after rest. Cytogenetic damage, knee retention and extra-articular spread of the radionuclide to regional lymph nodes, liver, urine and blood were evaluated. There was no significant difference in clinical response in the two treatment groups for either RA or OA. Chromosomal changes occurred with equal frequency and the knee retention and extra-articular leakage of radiocolloids to regional lymph nodes and liver were comparable in the two groups. For radiation synovectomy of the knee, 165Dy is at least as safe and as effective as 90Y and has the advantage of a short half-life (2.334 h) and hence requires a shorter period of post-injection immobilization and hospitalization.

KEY WORDS: Radiation synovectomy, Dysprosium-165, Yttrium-90, Rheumatoid synovitis, Osteoarthritis


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