"Synoren, Re-188" – a promising radiopharmaceutical for radiosynovectomy

«Radiation and Risk», 2018, vol. 27, No. 4, pp.76-86

DOI: 10.21870/0131-3878-2018-27-4-76-86


Kodina G.E. – Head of Dep., C. Sc., Chem., Assoc. Prof.
Malysheva A.O. – Sen. Res. Contacts: 46, Zhivopisnaya st., Moscow, Russia, 123182. Tel.: +7 (499) 190-95-81; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Klementyeva O.E. – Head of Lab., C. Sc., Biol.
Taratonenkova N.A. – Engineer.
Lyamtseva E.A. – Engineer.
Zhukova M.V. – Engineer.
Krasnoperova A.S. – Engineer.

State Research Center – Burnasyan Federal Medical Biophysical Center of FMBA, Moscow


The article presents results of investigation into efficiency of the new radiopharmaceutical (RPh) "Synoren,188Re" for synovitis treatment. The research was performed on laboratory animals with modeled joint pathology. The radiopharmaceutical can be produced as finished form or it can be prepared with the use of lyophilized reagents with the radionuclide generator 188W/188Re in laboratories for radionuclide studies and radionuclide therapy departments. Radiochemical purity of "Synoren,188Re" ≥90%. The RPh is a suspension with particle size of 2-10 μm, colloidal particles labeled with rhenium-188 are distributed homogeneously in the joint. The radiopharmaceutical was administered intra-articularly in the knee with modeled acute asymptomatic synovitis. "Synoren,188Re" has retained in the inflammation site for about three days after the administration. Therapeutic properties of "Synoren,188Re" were preserved for about 72 hours after the administration. Therapeutic efficiency was assessed by changes in locomotor activity as compared with the activity before the administration of the RPh. The follow up has lasted for a week after the administration of the "Synoren,188Re". Support ability of the damaged extremity in rats was assessed using the device, designed to study pain sensitivity in the absence of external pain stimulus, the ability in rabbits was measured by the distance running and pain severity on palpation of the damaged joint. The positive response to treatment was observed in all animals. After administration of the RPh improved support ability was registered in rabbits, reduction of pain intensity in the damaged joint was registered in rats. In animals of control groups (the RPh was not administered) no positive changes were observed. Therapeutic dose of the radiopharmaceutical did not produce toxic effect on normal tissues. Results of research strongly suggest that "Synoren,188Re" is an effective treatment for inflammatory joint diseases.

Key words
Radiopharmaceuticals, rhenium-188, radionuclide generator, radionuclide theraphy, radiosynovectomy, quality control, radiochemical purity, rheumatic diseases, rheumatoid arthritis, aseptic synovitis.


1. Alekseeva L.I., Chichasova N.V., Mendel O.I., Artemenko N.A., Zotkin E.G., Lesnyak O.M., Kudryavtseva N.V., Menshikova L.V. Rational choice of basic therapy for osteoarthritis. Russkiy meditsinskiy zhurnal – Russian Medical Journal, 2005, vol. 13, no. 24, pp. 1637-1640. (In Russian).

2. Nasonov E.L. Pharmacotherapy of rheumatoid arthritis from the perspective of evidence-based medicine: new recommendations. Russkiy meditsinskiy zhurnal – Russian Medical Journal, 2002, vol. 10, no. 6, pp. 294-302. (In Russian).

3. Ignat'yev V.K. Treatment of rheumatoid arthritis by intraarticular administration of gold-198. Klinicheskaya meditsina – Clinical Medicine, 1974, no. 8, pp. 52-55. (In Russian).

4. Zalewska J., Wegierska M., Barczynska T., Waszczak M., Żuchowski P., Jeka S. Efficacy of radiation synovectomy (radiosynovectomy or radiosynoviorthesis) with yttrium-90 in exudative inflammation of synovial membrane of knee joints in patients with rheumatic diseases – preliminary report. Reumatologia, 2016, vol. 54, no. 1, pp. 3-9.

5. Liepe K., Zaknun J., Padhy A., Barrenechea E., Soroa V., Shrikant S., Asavatanabodee P., Jeong M.J., Dondi M. Radiosynovectomy using yttrium-90, phosphorus-32 or rhenium-188 radiocolloids versus corticoid instillation for rheumatoid arthritis of the knee. Ann. Nucl. Med., 2011, vol. 25, no. 5, pp. 317-323.

6. Ansell B., Grook A., Mallard J., Bywaters E.G.L. Evaluation of intra-articular colloidal gold 198Au in the treatment of persistent knee effusions. Ann. Rheum. Dis., 1963, vol. 22, no. 6, pp. 435-439.

7. Arguelles M.G., Pereyra Molina V.E., Rutty Sola G.A., Cerizola M.V., Luppi Berlanga I.S., Bottazzini D.L. Preparation and evaluation of holmium-166 ferric hydroxide macroaggregates for radiation synovectomy. World J. Nucl. Med., 2002, vol. 1, suppl. 2, p. 174.

8. Argüelles M.G., Luppi Berlanga I.S., Torres E.A. Comparing particles for radiosynovectomy labeled with Ho-166. World J. Nucl.Med., 2002, vol. 1, suppl. 2, p. 300.

9. Bouyoucef S.E., Hanni-Haddam F., Sellah M., Bouyoucef S.E., Drahmoune R., Mechken F., Amimour A., Hanni-Haddam F., Abtroun F., Sellah M., Mansouri B. Treatment of persistent knee effusion with 90Y. World J. Nucl. Med., 2002, vol. 1, suppl. 2, p. 65.

10. Krylov V., Tsyb A., Drozdovsky B., Kodina G. Radionuclide therapy with 153Sm-oxabifore for rheumatic diseases. Radiopharmaceutical for Inflammation/Infection. Athens, MEDITERRA-Publishers, 2001, pp. 103-110.

11. Mikuls T.R., Kahn D., Utrie P.C. Samarium-153-EDTMP in the treatment of refractory rheumatoid arthritis. Scand. J Rheumatol., 2001, vol. 30, no. 6, pp. 356-359.

12. Wislowska M. Radiosynovectomy in rheumatic diseases. MOJ Orthoped & Rheumatol., 2016, vol. 5, no. 6: 00203. DOI: 10.15406/mojor.2016.05.00203.

13. Liepe K., Krylov V.V. Radiosynoviorthesis in the treatment of inflammatory joint diseases. Nauchno-prakticheskaya revmatologiya – Scientific and Practical Rheumatology, 2013, vol. 51, no. 6, pp. 714-720. (In Russian).

14. Pan'shin G.A. Pigmented villous-nodal synovitis. Part 1 (general issues). Vestnik Rossiyskogo nauchnogo Tsentra Rentgenoradiologii – Bulletin of the Russian Scientific Center of Roentgenology, 2016, no. 2, URL: http://vestnik.rncrr.ru/vestnik/v16/docs/Panshin.pdf (In Russian).

15. Wang S.J., Lin W.Y., Chen M.N., Chen J.T., Ho W.L., Hsieh B.T., Huang H., Shen L.H., Ting G., Knapp F.F., Jr. Histologic study of effects of radiation synovectomy with rhenium-188 microsphere. Nucl. Med. Biol., 2001, vol. 28, no. 6, pp. 727-732.

16. Liepe K. Radiosynovectomy in the therapeutic management of arthritis. World J. Nucl. Med., 2015, vol. 14, no. 1, pp. 10-15.

17. Jurgilewicz D. Scientific Meeting Report Radiosynovectomy – radionuclide treatment of synovitis in the peripheral joints. Nucl. Med. Rev. Cent. East Eur., 2012, vol. 15, no. 2, pp. 156-160.

18. Kamaleshwaran K.K., Rajamani V., Krishnan B., Mallia M., Kalarikal R., Mohanan V., Shinto A.S. Radiosynovectomy of proximal Interphalangeal joint synovitis in rheumatoid arthritis treated with rhenium-188 labeled tin-colloid and imaging with single-photon emission computerized tomography/computed tomog-raphy: a first case report. World J. Nucl. Med., 2015, vol. 14, no. 3, pp. 216-219.

19. Kodina G.E., Malysheva A.O., Klementyeva O.E., Lyamtseva E.A., Taratonenkova N.A., Voronitskaya N.N., Grafskova T.A., Semonenko N.N. Radiopharmaceutical composition for radiosynectomy and the method of its preparation. Patent N 2624237. 2017. Bulletin izobretenii no. 19. (In Russian).

20. Kodina G.E., Korsunsky V.N., Klementyeva O.E., Malysheva A.O., Zhukova M.V., Taratonenkova N.A. The first results of studying the biological behavior of a suspension based on Re, as a potential radiophar-maceutical for radiosynovectomy. Meditsinskaia radiologia i radiatsionnaia bezopasnost – Medical Radiology and Radiation Safety, 2014, vol. 59, no. 2, pp. 47-53. (In Russian).

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