Effect of Intra-Articular Yttrium-90 on Chronic Pyrophosphate Arthropathy of the Knee

Doherty, Michael; Dieppe, P A

doi:10.1016/s0140-6736(81)91488-4

Cited by 50 publications

(11 citation statements)

References 17 publications

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“…The systematic literature search yielded only 20 studies relevant for management of CPPD, including four randomised controlled trial (RCTs) 11–13. After reading the abstracts, 13 met the inclusion criteria, including six studies for acute attacks,14–19 two for prophylactic treatment to prevent recurrent acute attacks20 21 and five for management of chronic CPPD11–13 22 23.…”

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for calcium pyrophosphate deposition. Part II: Management

et al. 2011

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Objectives To develop evidence-based recommendations for management of calcium pyrophosphate deposition (CPPD). Methods A multidisciplinary guideline development group of 15 experts, representing 10 European countries, generated key propositions for management of CPPD using a Delphi consensus approach. For each recommendation research evidence was searched systematically. Whenever possible, the effect size and number needed to treat for effi cacy and RR or OR for side effects were calculated for individual treatment modalities. Strength of recommendation was assessed by the European League Against Rheumatism visual analogue scale. Results Nine key recommendations were generated, including topics for general management, treatment of acute attacks, prophylaxis against recurrent acute attacks and management of chronic symptoms. It was recommended that optimal treatment requires both non-pharmacological and pharmacological treatments. For acute CPP crystal arthritis, cool packs, temporary rest and joint aspiration combined with steroid injection are often suffi cient. For prophylaxis or chronic infl ammatory arthritis with CPPD, oral non-steroidal anti-infl ammatory drugs with gastroprotective treatment and/or low-dose colchicine 0.5-1.0 mg daily may be used. Other recommendations included parenteral or oral corticosteroid for acute CPP arthritis in those unresponsive or unsuited to other measures, and lowdose corticosteroid, methotrexate or hydroxychloroquine for chronic infl ammatory arthritis with CPPD. Asymptomatic CPPD requires no treatment. Strength of recommendations varies from 79% to 95%. Conclusion Nine key recommendations for management of CPP crystal associated arthritis were developed using both research evidence and expert consensus. Strength of recommendations was provided to assist the application of these recommendations.

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Section: Resultsmentioning

confidence: 99%

EULAR recommendations for calcium pyrophosphate deposition. Part II: Management

et al. 2011

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“…Einige Untersuchungen ergaben eine Überlegenheit der Radiosynoviorthese gegenüber der intraartikulären Glukokortikoid-Injektion, u.a. bei Patienten mit Chondrocalcinose [8].…”

Section: Vergleichsstudien Mit Glukokortikoidenunclassified

Radiosynoviorthese

Seidel

DGRh²

2006

Z. Rheumatol.

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Intraarticular therapy is an established form of therapy in chronic inflammatory joint diseases. Besides the injection of glucocorticoids, radiosynoviorthesis is a frequently used procedure. Intraarticular injected beta-emitting radionuclides are indicated in chronic synovitis with recurrent joint effusions in rheumatoid arthritis, seronegative spondyloarthritis, villonodular synovitis after surgery and for bleeding prophylaxis in haemophilic arthropathy. The value of radiosynoviorthesis in activated osteoarthritis is not yet clarified.

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“…Surgical and chemical synovectomy has been shown to have some benefit in patients RA. A small controlled trial of yttrium chemical synovectomy in patients with OA associated with chondrocalcinosis, has demonstrated much improved symptomatic relief of pain lasting over six months [40]. The place of this therapeutic intervention in OA requires further analysis.…”

Section: Glycosaminoglycansmentioning

confidence: 99%

Novel strategies for the treatment of osteoarthritis

Chikanza¹,

Fernandes²

2000

Expert Opinion on Investigational Drugs

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Osteoarthritis is a worldwide heterogeneous group of conditions that leads to joint symptoms, which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins. The prevalence of the disease after the age of 65 years, is about 60% in men and 70% in women. The aetiology of osteoarthritis is multifactorial, with the end result being mechanical joint failure and varying degrees of loss of joint function. The pathophysiological events associated with osteoarthritis are beginning to be understood. Essential inflammatory cytokines, such as IL-1beta and TNF-alpha, are involved initiating a vicious cycle of catabolic and degradative events in cartilage, mediated by metalloproteinases, which degrade cartilage extracellular matrix. The role of inflammation in the pathophysiology and progression of early osteoarthritis is supported further by the observation that C-reactive protein levels are raised in women with early knee osteoarthritis and higher levels predict those whose disease will progress. The synovium from osteoarthritis joints stains for IL-1beta and TNF-alpha. Nitric oxide, which exerts pro-inflammatory effects, is released during inflammation. Cartilage from patients with rheumatoid arthritis and osteoarthritis spontaneously produces nitric oxide in vitro. In experimental osteoarthritis, nitric oxide induces chondrocyte apoptosis, thus contributing to cartilage degradation. Hence unregulated nitric oxide production in humans plays a part in the pathophysiology of the disease. These recent observations suggest that therapy can now be targeted at specific sites of pathophysiological pathways involved in the pathogenesis of osteoarthritis. The novel strategies under consideration for the treatment of osteoarthritis can be divided into five main areas. These are COX-2 inhibitors, nitric oxide synthesis inhibitors and anti-oxidants, chondrocyte and bone growth promoters, metalloproteinase and cytokine inhibitors and gene therapy.

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Effect of Intra-Articular Yttrium-90 on Chronic Pyrophosphate Arthropathy of the Knee

Cited by 50 publications

References 17 publications

EULAR recommendations for calcium pyrophosphate deposition. Part II: Management

EULAR recommendations for calcium pyrophosphate deposition. Part II: Management

Radiosynoviorthese

Novel strategies for the treatment of osteoarthritis

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