Effectiveness of radiation synovectomy with samarium-153 particulate hydroxyapatite in rheumatoid arthritis patients with knee synovitis: a controlled randomized double-blind trial

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dc.contributor.authorSantos, Marla Francisca dos [UNIFESP]
dc.contributor.authorFurtado, Rita Nely Vilar [UNIFESP]
dc.contributor.authorKonai, Monique Sayuri [UNIFESP]
dc.contributor.authorCastiglioni, Mario Luiz Vieira [UNIFESP]
dc.contributor.authorMarchetti, Renata Rosa [UNIFESP]
dc.contributor.authorNatour, Jamil [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2015-06-14T13:39:01Z
dc.date.available2015-06-14T13:39:01Z
dc.date.issued2009-01-01
dc.description.abstractOBJECTIVES: The aim of the present study was to investigate the effectiveness of Samarium153-particulate hydroxyapatite radiation synovectomy in rheumatoid arthritis patients with chronic knee synovitis. METHODS: Fifty-eight rheumatoid arthritis patients (60 knees) with chronic knee synovitis participated in a controlled double-blinded trial. Patients were randomized to receive either an intra-articular injection with 40 mg triamcinolone hexacetonide alone (TH group) or 40 mg triamcinolone hexacetonide combined with 15 mCi Samarium153-particulate hydroxyapatite (Sm/TH group). Blinded examination at baseline (T0) and at 1 (T1), 4 (T4), 12 (T12), 32 (T32), and 48 (T48) weeks post-intervention were performed on all patients and included a visual analog scale for joint pain and swelling as well as data on morning stiffness, flexion, extension, knee circumference, Likert scale of improvement, percentage of improvement, SF-36 generic quality of life questionnaire, Stanford Health Assessment Questionnaire (HAQ), Lequesne index, use of non-steroidal anti-inflammatory drugs or oral corticosteroids, events and adverse effects, calls to the physician, and hospital visits. RESULTS: The sample was homogeneous at baseline, and there were no withdrawals. Improvement was observed in both groups in relation to T0, but no statistically significant differences between groups were observed regarding all variables at the time points studied. The Sm/TH group exhibited more adverse effects at T1 (p<0.05), but these were mild and transitory. No severe adverse effects were reported during follow-up. CONCLUSION: Intra-articular injection of Samarium153-particulate hydroxyapatite (15 mCi) with 40 mg of triamcinolone hexacetonide is not superior to triamcinolone hexacetonide alone for the treatment of knee synovitis in patients with rheumatoid arthritis at 1 y of follow-up.en
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Division of Rheumatology
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of Radiology
dc.description.affiliationUnifespUNIFESP, EPM, Division of Rheumatology
dc.description.affiliationUnifespUNIFESP, EPM, Department of Radiology
dc.description.sourceSciELO
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.format.extent1187-1193
dc.identifierhttp://dx.doi.org/10.1590/S1807-59322009001200008
dc.identifier.citationClinics. Faculdade de Medicina / USP, v. 64, n. 12, p. 1187-1193, 2009.
dc.identifier.doi10.1590/S1807-59322009001200008
dc.identifier.fileS1807-59322009001200008.pdf
dc.identifier.issn1807-5932
dc.identifier.scieloS1807-59322009001200008
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/4836
dc.identifier.wosWOS:000273059400008
dc.language.isoeng
dc.publisherFaculdade de Medicina / USP
dc.relation.ispartofClinics
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectRheumatoid arthritisen
dc.subjectIntra-articular injectionen
dc.subjectRadiosynoviorthesisen
dc.subjectRadiation synovectomyen
dc.subjectSamariumen
dc.titleEffectiveness of radiation synovectomy with samarium-153 particulate hydroxyapatite in rheumatoid arthritis patients with knee synovitis: a controlled randomized double-blind trialen
dc.typeinfo:eu-repo/semantics/article
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