Effect Of Technetium[⁹⁹Tc] Methylene Diphosphonate For Short-term Treatment Of Rheumatoid Arthritis

Objective:To observe the efficacy and safety of Technetium[99Tc] methylene diphosphonate injection for short-term treatment of active rheumatoid arthritis(RA) and the effect to the levels of dickkopf-1 (DKK-1) in serum.Methods:30 patients with active RA were randomly divided into control group, technetium[99Tc] methylene diphosphonate group and combinational group.10 patients in control group were treated with daily oral meloxicam(15mg).10 patients in technetium[99Tc] methylene diphosphonate group were treated with daily intravenous drip technetium[99Tc] methylene diphosphonate injection(20mg).10 patients in combinational group were treated with daily intravenous drip technetium[99Tc] methylene diphosphonate injection(20mg) plus daily oral meloxicam(15mg).The course of treatment was 14 days. Clinical effect was assessed with the American College of Rheumatology (ACR)criteria and Disease activity score(DAS) 28.The levels of DKK-1 in serum were determined by Enzyme-Linked Immunosorbent Assay (ELISA).Results:â‘ A total of 26 of 30 patients finished the study. At 14th day, there were no significant improvements in the clinical symptoms(pain degree,subjects score,researchers score,morning stiffness,swollen joint count,tender joint count,HAQ) and laboratory indices(ESR, CRP, RF, anti-CCP) of the three groups.One patient achieved ACR20 and one patient achieved ACR50 in control group. Three patients achieved ACR20 in technetium[99Tc] methylene diphosphonate group.One patient achieved ACR20 and one patient achieved ACR50 in combinational group.There were no significant improvements in the ACR20 and ACR50 responses of the three group(P >0.05).â‘¡At 14th days, the DAS28 had a significant improvement in technetium[99Tc] methylene diphosphonate group (P<0.05). There was no significant improvement in the DSA28 of the control group and the combinational group (P>0.05).â‘¢The levels of DKK-1 in the three groups were not significantly different before and after being treated (P >0.05).There were no significant differences in the levels of DKK-1 of the three groups before and after treatment(P>0.05).â‘£One patient in technetium[99Tc] methylene diphosphonate group presented with a flushing after intravenous drip technetium[99Tc] methylene diphosphonate injection, and relieved without special treatment.The three groups did not develop injection site reaction, leukopenia, urticaria, infection, dyspepsia, elevated aminotransferases, hair loss, dry mouth, abdominal pain, the incidence of malignant tumors. The three groups were well-toleranted, and there were no significant differences among them(P> 0.05)Conclusion:Technetium[99Tc] methylene diphosphonate doesn't show significant short-term efficacy in patients with active RA, but it is well-toleranted and safety.It has no effect on the levels of DKK-1 in RA patients'sera in short-term treatment.