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Double-blind randomized controlled trial and six-year open follow-up of yttrium-90 radiosynovectomy versus triamcinolone hexacetonide in persistent rheumatoid knee synovitis

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An Erratum to this article was published on 01 December 1992

Abstract

Knee joints (n=30) from 22 adult rheumatoid arthritis (RA) patients who were previously randomized and subjected to a six-month double-blind controlled trial of yttrium-90 vs. triamcinolone hexacetonide with a six-year follow-up. In contrast to most previous studies, there was no co-administration of a steroid agent at the time the radiopharmaceutical was injected. One month after treatment the triamcinolone group had less pain (p<0.05), fewer effusions (p<0.001) and a better range of movement (p<0.01) than the yttrium group. Six months after treatment, the response in the triamcinolone group had partially regressed but was still superior to that of the yttrium group (p<0.05). At the six-year follow-up, half the yttrium-treated knees were found to have required treatment by intra-articular steroid, surgical synovectomy or total knee arthroplasty. The rates for therapeutic success were no different for yttrium-90 or triamcinolone. These results bring into question the reported efficacy of yttrium-90 and suggest that the benefit observed in clinical practice may be dependent upon the co-administration of a corticosteroid agent, and that the long-term benefits of yttrium may be relatively small.

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Authors and Affiliations

  1. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

    E. N. Grant

  2. Department of Medicine, University of Western Ontario, London, Ontario, Canada

    N. Bellamy, K. Fryday-Field, T. Disney & K. Hobby

  3. Department of Nuclear Medicine, University of Western Ontario, London, Ontario, Canada

    A. Driedger

Authors
  1. E. N. Grant
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  2. N. Bellamy
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  3. K. Fryday-Field
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  4. T. Disney
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  5. A. Driedger
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  6. K. Hobby
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Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/BF02755888.

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Grant, E.N., Bellamy, N., Fryday-Field, K. et al. Double-blind randomized controlled trial and six-year open follow-up of yttrium-90 radiosynovectomy versus triamcinolone hexacetonide in persistent rheumatoid knee synovitis. Inflammopharmacology 1, 231–238 (1992). https://doi.org/10.1007/BF02735372

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  • DOI: https://doi.org/10.1007/BF02735372

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