96, respectively. Of the 129/167 joints that responded to treatment at 3 months, 116/129 (90%) had reached the 36-month time point at the time of analysis. Of these 116 patients, 68/116 (59%; 95%CI 49–67%) had a sustained clinical response at 36 months. A strong trend was demonstrated between the degree of initial clinical response and duration ABT-199 order of response with 90% of
complete responders compared to 55% of moderate responders (P = 0.0005) and 55% of moderate responders compared to 23% of mild responders (P = 0.01) maintaining their response at 36 months. This trend was maintained across all arthopathy groups (Table 4). Potentially serious complications
occurred in 2/167 cases (1%) in the first 3 months post-treatment. One intra-articular hemorrhage occurred in a hemophilia patient despite Akt assay appropriate factor replacement prior to the procedure and one extra-articular injection occurred during an attempted hip joint injection. No cases of skin necrosis occurred and the two reported cases did not appear to have any long-term adverse sequelae. We demonstrated an overall satisfactory clinical response rate to yttrium synovectomy of 57% across all arthropathies treated between January 2000 and December 2010. Large joint monoarthropathies demonstrated a particularly favorable response with 85% achieving a satisfactory clinical response compared to 52% for rheumatoid, psoriatic and hemophilic arthropathies combined (P = 0.006). A strong relationship between the degree of initial response and duration of response was demonstrated with those patients achieving a complete response in the first 3 months having a much higher likelihood (90%) of a sustained response at 36 months. We demonstrated no difference in response rates to yttrium synovectomy pre- and post-availability of newer generation DMARDs at our institution, with 41% of rheumatoid P-type ATPase and psoriatic arthropathies achieving satisfactory clinical response pre-2005
compared to 57% post-2005 (P = 0.25). Similarly, no difference in response rates was demonstrated pre- and post-introduction of routine factor replacement therapy in hemophiliac patients at our institution, with 50% of hemophilic arthropathies achieving satisfactory clinical response pre-2005 compared to 44% post-2005 (P = 0.96). Yttrium synovectomy was well tolerated in all patients in our study with a low overall complication rate of 1%. Importantly, no major adverse clinical outcomes were encountered such as skin necrosis or ulceration. The overall satisfactory clinical response rate of 57% in our study is concordant with the literature, with response rates commonly reported in the range of 50–80%.