Repeated Radiosynovectomy in Haemophilia: Revealing Long-Term Effectiveness and Safety

Introduction

Radiosynovectomy (RS), which uses beta particle-emitting radiocolloids, has proven highly effective in significantly reducing the occurrence of haemarthroses and breaking the cycle of bleeding and synovitis. This study now presents the long-term outcomes of repeated RS in individuals with haemophilia.

Materials and Methods

Repeated RS was administered to 48 joints in 37 people with haemophilia (PwHs) diagnosed with chronic haemophilic synovitis. The frequency of bleeding episodes was meticulously recorded during the 6-month periods preceding and following each of the initial and subsequent RS procedures. Treatment failure was designated by the necessity for additional RS injections.

Results

The results for 48 joints were analysed. The mean bleeding frequency of the joints was 12.5 ± 7.29 (median 10) within the last 6 months in the pre-treatment evaluation and after the treatment, the mean bleeding frequency of the joints decreased to 2.25 ± 3.82 (median 0.5) for the first 6 months (p < 0.001) after the first RS. The mean survival of the first intervention was 40.52 ± 33.79 months (range, 1–124 months). In the second RS, the mean bleeding frequency of the joints was 10.29 ± 7.66 (median 8) within the last 6 months in the pre-treatment evaluation and after the treatment, and the mean bleeding frequency of the joints decreased to 0.93 ± 1.69 (median 0) for the first 6 months (p < 0.001). The survival rate of the second RS was 94% at 12 months, and 87% at 36 months.

Conclusion

Repeated RS was proven to be an effective and safe treatment for Pwh with recurrent bleeding episodes during long-term follow up. Thirty-six months survival rate was 87% (42 of 48 joints).