SUMMARY Erbium-169 was compared with triamcinolone hexacetonide in the topical treatment of 32 patients suffering from rheumatoid arthritis. Erbium-169 was injected into 83 and triamcinolone hexacetonide into 54 proximal interphalangeal or metacarpophalangeal joints. Both treatments produced alleviation ofjoint pain and swelling and improvement of grip strength. At every check-up (1-18 months) the percentage of remissions was higher after triamcinolone hexacetonide injection than after erbium-169. The difference was significant at 1, 3, and 6 months.Intra-articular injection of the beta-emitter erbium-169 (e69Er) has been used with success in the treatment of rheumatoid finger joints (Menkes et al., 1974). The result after 1 year was very good or good in 54% of cases. The radionuclide was injected with prednisolone acetate. In another study the effect of 169Er (+ prednisolone acetate) was compared with that of saline (+ steroid). The rate of improvement after 6-12 months was significantly higher with 169Er than with saline (Menkes et al., 1977).In the present study we have evaluated the effects of 169Er in comparison with triamcinolone hexacetonide (TCHA). We also calculated the radiation doses in the synovium and axillary lymph nodes.
Patients and methods169Er has a half-life of 9 5 days. It radiates betaparticles with a maximum energy of 340 keV (av. 100). The effective half-value attenuation layer is 0'1 mm. The agent is administered as a colloidal citrate suspension, pH 7, mean particle diameter 10 nm (Commissariat A l'energie atomique, Saclay).For the proximal interphalangeal joints the dose used was 0 25 mCi and for the metacarpophalangeal joints 0 * 5 mCi. After treatment the joint was splinted for 3 days to reduce leakage of the radionuclide (Oka et al., 1971). The leakage of the injected 169Er activity was measured in the axillary lymph nodes 3-5 days after treatment. No steroid was injected with 169Er. The dose of TCHA for the control joints was
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.