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).