Open AccessAdministration of lower doses of radium-224 to ankylosing spondylitis patients results in no evidence of significant overall detriment
Author(s) -
Nicholas Priest,
Lawrence T. Dauer,
David G. Hoel
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0232597
Subject(s) - ankylosing spondylitis , medicine , radium , incidence (geometry) , cancer , population , epidemiology , spondylitis , cause of death , surgery , environmental health , disease , physics , nuclear physics , optics
The use of low doses of radium-224 ( 224 Ra) chloride for the treatment of ankylosing spondylitis was stopped following the discovery that patients treated with it had a higher than control incidence of leukaemia and other cancers. This was so even though the treatment resulted in decreased pain and increased mobility–both of which are associated with decreased mortality. It was decided to re-analyze the epidemiological data looking at all causes of death. The risk of leukaemia, solid cancer, death from non-cancer causes and from all causes in a study populations of men that received either the typical dose of 5.6 to 11.1 MBq of 224 Ra, any dose of 224 Ra or no radium were compared using the Cox proportional hazard model. For patients that received the typical dose of 224 Ra agreed with the excess cancer was similar to that reported in previous studies. In contrast, these patients were less likely to die from non-cancer diseases and from all causes of death than the control patients. No excess mortality was also found in the population of all males that received the radionuclide. It is concluded that 224 Ra treatment administered at low doses to patients with ankylosing spondylitis did not impact mortality from all causes. The study demonstrates the need to consider all causes of death and longevity when assessing health impacts following irradiation.