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Erbium-169 citrate is a therapeutic radiopharmaceutical used for radiosynovectomy (radiosynoviorthesis) of small joints, such as the metacarpophalangeal and proximal interphalangeal joints. Developed by CIS Bio International, it consists of the radioactive isotope erbium-169 in a colloidal citrate form. Following intra-articular injection, the radioactive particles are taken up by the superficial synovial cells. The isotope decays primarily via beta emission with a very short tissue penetration range (average 0.3 mm), which allows for the targeted destruction (necrosis) of the inflamed synovial layer while minimizing radiation exposure to surrounding healthy tissues like cartilage and bone. It is typically indicated for patients with rheumatoid arthritis or seronegative spondyloarthropathy who have not responded to intra-articular corticosteroid injections.
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