Effect of radiosynoviorthesis on the progression of arthropathy and haemarthrosis reduction in haemophilic patients

Querol-Giner, M.; Pérez‐Alenda, Sofía; Aguilar‐Rodríguez, Marta; Carrasco, Juan J.; Bonanad, Santiago; Querol, Felipe

doi:10.1111/hae.13326

Cited by 14 publications

(13 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In another study by Thomas et al, 18 Y‐90 radiosynovectomy significantly reduced the number of bleeding episodes in 245 joints of 190 heterogeneous patient group irrespective of the radiographic stage and inhibitor status. Additionally, the efficacy and safety of RS were reported from several centres in the literature 19‐24 . In the present series of PwHs with inhibitor cohort, median follow‐up was 82.7 ± 61.4 months and 33 joints (70.2%) had no failure of therapy while the cumulative survival rate at 12 months was 87% and 78% at 36 months.…”

Section: Discussionmentioning

confidence: 60%

Prognostic factors of radiosynovectomy in haemophilia patients with inhibitors: Survival analysis in a 19‐year period

et al. 2020

View full text Add to dashboard Cite

Introduction: People with haemophilia (PwH) with inhibitors have an increased risk of bleeding and early development of progressive arthropathy. Radiosynovectomy (RS) has been effective in dramatically reducing the frequency of haemarthroses. In the present study, the mid-and long-term results of the efficacy of RS in PwHs with inhibitors and prognostic factors that influence success and failure of RS were presented. Material and Method: Radiosynovectomy was performed in 51 joints of 22 PwHs with inhibitors diagnosed with chronic haemophilic synovitis between January 2000 and December 2018. Two patients were lost to follow-up and four joints were excluded. Number of bleeding episodes within the pre-and post-treatment 6 months were documented. Treatment failure was defined as need for repeat RS injection. Results: Results of 47 RS were analysed. The mean bleeding frequency of the joints was 11.2 ± 6.2 (median 9) within the last 6 months in the pre-treatment evaluation. After the treatment, the mean bleeding frequency of the joints decreased to 1.2 ± 2.8 (median 0) for first 6 months (P < .0001). The cumulative survival rate at 12 months was 87% and 78% at 36 months. The receiver operating characteristic (ROC) curve analysis revealed that cutoff points of 12 bleeding episodes within the last 6 months (sensitivity, 71.4; specificity, 81.8 P = .0022) and an inhibitor titre of 63.4 BU (sensitivity, 57.1; specificity, 75.8; P = .31) were threshold levels for a predisposition for failure. Conclusion: Radiosynovectomy is an effective and safe intervention in PwHs with inhibitors. Bleeding frequency is a prognostic marker for the success of RS treatment. Patients who have more than 12 bleeding episodes within the last 6 months before the RS treatment have a higher rate of failure.

show abstract

Section: Discussionmentioning

confidence: 60%

Prognostic factors of radiosynovectomy in haemophilia patients with inhibitors: Survival analysis in a 19‐year period

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The best results are achieved before the onset of hemarthropathy and are best in ankle joints, followed by elbows and knee joints [ 71 , 73 ]. A more recent study suggests that RSO slows the development of hemarthropathy in younger patients, but it remains uncertain whether RSO prevents hemarthropathy [ 74 ].…”

Section: Indications For Radiosynoviorthesismentioning

confidence: 99%

The EANM guideline for radiosynoviorthesis

Kampen¹,

Boddenberg-Pätzold

Fischer³

et al. 2021

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Purpose Radiosynoviorthesis (RSO) using the intraarticular application of beta-particle emitting radiocolloids has for decades been used for the local treatment of inflammatory joint diseases. The injected radiopharmaceuticals are phagocytized by the superficial macrophages of the synovial membrane, resulting in sclerosis and fibrosis of the formerly inflamed tissue, finally leading to reduced joint effusion and alleviation of joint pain. Methods The European Association of Nuclear Medicine (EANM) has written and approved these guidelines in tight collaboration with an international team of clinical experts, including rheumatologists. Besides clinical and procedural aspects, different national legislative issues, dosimetric considerations, possible complications, and side effects are addressed. Conclusion These guidelines will assist nuclear medicine physicians in performing radiosynoviorthesis. Since there are differences regarding the radiopharmaceuticals approved for RSO and the official indications between several European countries, this guideline can only give a framework that must be adopted individually.

show abstract

“…This reduces hypertrophy [ 105 ]. Radiosynoviorthesis also significantly reduces bleeding and there even are indications that the progression of arthrosis may be slowed down [ 106 ].…”

Section: Pain Therapy In Hemophilia Patientsmentioning

confidence: 99%

Pain management in hemophilia: expert recommendations

Stromer¹,

Pabinger

et al. 2021

Wien Klin Wochenschr

View full text Add to dashboard Cite

Summary Introduction As a typical consequence of bleeding into muscles and joints, patients with severe hemophilia suffer from acute and chronic pain. In spite of its high prevalence, pain in this patient group is not always sufficiently considered or treated in an effective manner. Aim The recommendations presented in this paper address possible improvements in pain management in hemophilia patients and particularities that have to be taken into account in this patient group. Method The manifold aspects of pain management in hemophilia patients were discussed within the framework of an expert meeting. Based on the available literature and the experts’ clinical experience, the participants developed a set of recommendations presented in this paper. Results Pain management in patients with hemophilia is often insufficient, a fact that not only influences the patients’ quality of life but also implies the risk of difficult to manage chronic pain. Both the prevalent polypharmacy (due to comorbidities) as well as the underlying disease itself present special challenges to pain therapy in this patient group. The present review and recommendations are intended to support medical professionals in recognising the risks of pain chronicity, applying basic principles of multimodal pain therapy, including the options of psychological intervention and modalities of physical medicine in therapy concepts, and reaching a comprehensive understanding of the range of analgesic options available.

show abstract

Effect of radiosynoviorthesis on the progression of arthropathy and haemarthrosis reduction in haemophilic patients

Cited by 14 publications

References 30 publications

Prognostic factors of radiosynovectomy in haemophilia patients with inhibitors: Survival analysis in a 19‐year period

Prognostic factors of radiosynovectomy in haemophilia patients with inhibitors: Survival analysis in a 19‐year period

The EANM guideline for radiosynoviorthesis

Pain management in hemophilia: expert recommendations

Contact Info

Product

Resources

About