Results of safety study of radiopharmaceutical drug preparation based on albumin microspheres of 5-10 μm diameter labeled with rhenium-188

«Radiation and Risk», 2025, vol. 34, No. 4, pp.160-172

DOI: 10.21870/0131-3878-2025-34-4-160-172

Authors

Petrosyan K.M. – Radiologist. Contact: 4 Korolyov str., Obninsk, Kaluga Region, Russia, 249035. Tel: +7(980)514-72-07; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Krylov V.V. – Head of Dep., MD
Lugovaya A.V. – Radiologist
Vlasova O.P. – Lead. Researcher, C. Sc., Biol.
Sigov M.A. – Acting Head of D.
Stepanenko V.F. – Head of Lab., D. Sc., Biol.
Bogacheva V.V. – Sen. Researcher, C. Sc., Biol.
Tishchenko V.K.– Acting Head of Lab., D. Sc., Biol.
Spichenkova O.N. – Lead Engineer
Ivanov S.A. – Director, Corr. Member of RAS, MD, Prof. of RUDN University Dep. A. Tsyb MRRC
Kaprin A.D. – General Director, Director of P. Hertsen MORI, Head of RUDN University Dep., Academician of RAS, MD, Prof. NMRRC.
1 A. Tsyb MRRC, Obninsk
2 Peoples' Friendship University of Russia named after Patrice Lumumba, Moscow
3 NMRRC, Obninsk
4 P. Hertsen MORI, Moscow

Abstract

Inflammatory joint diseases, such as rheumatoid, psoriatic, reactive arthritis, ankylosing spondylitis, reactive and other arthritis, lead to significant loss of quality of life and are frequent causes of disability. These diseases are accompanied by synovitis, which continues to progress despite the ongoing basic therapy. Radiosynovectomy (RSE) is one of the effective methods of treatment of such patients. A radiopharmaceutical drug based on human blood albumin microspheres with a diameter of 5-10 μm labeled with rhenium-188 for the treatment of knee arthrosis (Arthroren-MRRC) was developed at the A. Tsyb MRRC. The results of phase 1 clinical trials are presented, the aim of which is to study the tolerability, safety and pharmacokinetics of the drug during knee joint RSE (single intra-articular injection for the treatment of chronic recurrent synovitis); to study the increasing activities (370, 555, 740 and 925 MBq), to evaluate the radiation doses, the effect of RSE with the use of radiopharma-ceutical on the quality of life of patients, radiation exposure to personnel. 20 patients (18-75 years old) with recurrent chronic synovitis of the knee joint underwent RSE with injection of 188Re MCA 5-10 μm with activity ranging from 370 to 925 MBq. After injection, the following was performed: time-lapse SPECT/CT scintigraphy (1-72), radiometry of urine taken within 48 h after RSE and estimation of absorbed internal radiation doses to the synovial membrane and organs at risk. The absorbed doses formed after RSE in the knee joint in patients ranged from 17.5 to 74 Gy, and the doses to the organs at risk were many times lower than the generally accepted dose limits. High safety and good tolerability of radiopharmaceutical (188Re MCA 5-10 μm) was demonstrated. The activity of 740 MBq appeared to be optimal in terms of safety and efficacy in knee joint RSE.

Key words
nuclear medicine, radiology, radiosynovectomy, synovitis, knee joint, albumin microspheres, 188Re, radiopharmaceutical, “Arthroren-MRRC”, clinical trials, absorbed dose.

References

1. Vyalkov A.I., Gusev E.I., Zborovsky A.B., Nasonova V.A. The main tasks of the International Decade (The Bone and Joint Decade 2000-2010) in improving the fight against the most common diseases of the muscu-loskeletal system in Russia. Nauchno-prakticheskaya revmatologiya – Rheumatology Science and Practice, 2001, vol. 39, no. 2, pp. 4-8. (In Russian).

2. Liepe K., Krylov V.V. Radiosynoviorthesis in the treatment of inflammatory diseases of joints. Nauchno-praktich-eskaya revmatologiya – Rheumatology Science and Practice, 2013, vol. 51, no. 6, pp. 714-720. (In Russian).

3. Balabanova R.M., Olyunin Yu.A., Lila A.M. Radioisotope synovectomy in the treatment of patients with rheumatoid arthritis. Sovremennaya revmatologiya – Modern Rheumatology Journal, 2019, no. 1, pp. 101-107. (In Russian).

4. Mazurov V.I. Diseases of joints: a manual for physicians. St. Petersburg, SpetsLit, 2008. 397 p. (In Russian).

5. Gerasimenko M.A., Beletskii A.V. Diagnostics and treatment of injuries and orthopedic diseases of the knee joint. Minsk, 2010, 167 p. (In Russian).

6. Zverev A.V., Krylov V.V., Khanov A.G., Kochetova T.Yu. Radiosynovectomy – a method of treatment of inflammatory joint diseases using isotopes. RMG. Meditsinskoe Obozrenie – Russian Medical Inquiry, 2017, no. 1, pp. 36-41. (In Russian).

7. American College of Rheumatology Ad Hoc Committee on Clinical Guidelines. 1. Guidelines for the management of rheumatoid arthritis. Arthritis Rheum., 2002, vol. 46, no. 2. pp. 328-346.

8. Rheumatoid arthritis. Federal clinical guidelines of the Association of Rheumatologists of Russia. Moscow, 2013, with an addition in 2016. 30 p. (In Russian).

9. Production, quality control and clinical applications of radiosynovectomy agents. IAEA Technical Report Series. Vienna, IAEA, 2019. 163 p.

10. Liepe K., Zaknun J.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.

11. Liepe K., Andreeff M., Wunderlich G., Kotzerke J. Radiation protection in radiosynovectomy of the knee. Health Phys., 2005, vol. 89, no. 2, pp. 151-154.

12. Therapeutic radionuclide generators: 90Sr/90Y and 188W/188Re generators. IAEA Technical Reports Series No. 470. Vienna, IAEA, 2009. 233 p.

13. Lepareur N., Lacoeuille F., Bouvry C., Hindré F., Garcion E., Chérel M., Noiret N., Garin E., Knapp F.F.R. Jr. Rhenium-188 labeled radiopharmaceuticals: current clinical applications in oncology and promising perspec-tives. Front. Med. (Lausanne), 2019, vol. 6, pp. 132. DOI: 10.3389/fmed.2019.00132.

14. Uyba V.V. Nuclear medicine. Reference book. Moscow, FMBA of Russia, 2019. 347 p. (In Russian).

15. Zverev A.V., Klementieva O.E., Zhukova M.V., Krasnoperova A.S. Preclinical evaluation of the therapeutic potential of a radiopharmaceutical drug based on 5-10 micron albumin microspheres with rhenium-188. Russian Medical Journal, 2018, no. 4(I), pp. 31-35. (In Russian).

16. Stepchenkova E.D., Tishchenko V.K., Vlasova O.P., Petriev V.M., Legkodimova N.S., Krylov V.V., Fedorova A.V., Kuzenkova E.A., Ostroukhov A.A., Shegai P.V. Radioactivity distribution in the blood and urine of patients receiving systemic therapy with a 177Lu radiopharmaceutical and local (intra-articular) therapy with a 188Re radiopharmaceutical. Vedomosti Nauchnogo tsentra ekspertizy sredstv meditsinskogo prime-neniya. Regulyatornyye issledovaniya i ekspertiza lekarstvennykh sredstv – Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products. Regulatory Research and Medicine Evaluation, 2022, vol. 12, no. 4, pp. 404-414. (In Russian).

17. Stepanenko V.F., Petriev V.M., Caprin A.D., Ivanov S.A., Shegay P.V., Bogacheva V.V., Kolyzhenkov T.V., Petukhov A.D., Krylov V.V., Kucherov V.V., Sigov M.A., Vlasova O.P., Petrosyan A.P., Petrosyan K.M., Spichenkova O.N., Ivannikov A.I., Khaylov A.M., Korotkov V.A., Zharova E.P., Eremeyev M.R. Person-alized dosimetry of internal irradiation of tumor formations and risk organs of patients: development and im-plementation of the methodological basis for dosimetric support of clinical trials of therapeutic radiopharma-ceuticals. Radiatsiya i risk – Radiation and Risk, 2023, vol. 32, no. 1, pp. 156-167. (In Russian).

18. Stepanenko V.F., Bogacheva V.V., Dorokhov A.V., Petukhov A.D., Kucherov V.V., Krylov V.V., Petro-syan A.P., Kochetova T.Yu., Kaprin A.D. Calculation of spatial distributions of absorbed energy of ionizing radiation in biological tissue for extended biostructures under internal irradiation with alpha-particles, electrons and photons with different energies: unified approach for application in nuclear medicine. Radiatsiya i risk – Radiation and Risk, 2025, vol. 34, no. 1, pp. 82-94. (In Russian).

19. Radiopharmaceutical composition for therapy of inflammatory joint diseases based on rhenium-188 radionu-clide and human blood albumin microspheres, as well as composition and method of its preparation. Patent of the Russian Federation N 2698101 from 25.05.2018. (In Russian).

20. Krylov V.V., Legkodimova N.S., Kochetova T.Yu., Petriev V.M., Sigov M.A., Tishchenko V.K, Pronin A.I., Shurinov A.Yu., Petrosyan K.M., Spichenkova O.N., Karyakin O.B., Biryukov V.A., Stepanenko V.F., Vlasova O.P., Shegaj P.V., Ivanov S.A., Kaprin A.D. Radioligand therapy with 177Lu-DOTA-PSMA in metastatic castration-resistant prostate cancer. Pharmacokinetics, safety, antitumour efficacy. Luchevaya di-agnostika i terapiya – Diagnostic Radiology and Radiotherapy, 2022, vol. 13, no. 4. pp. 75-85. (In Russian).

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