Chemical synoviorthesis with osmic acid in haemophilia

Ayral, X.

doi:10.1046/j.1365-2516.2001.00104.x

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…The overall effects of RS and prophylaxis are favourable, which have already been reported by a number of authors. In all the studies, RS proved to be efficient regardless of the type of isotope [14,[16][17][18][19][20][21][22] or even chemical substance that was used [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

The co effect of prophylaxis and radiosynovectomy on bleeding episodes in haemophilic synovitis

Brecelj

Bole²,

Benedik-Dolničar

et al. 2008

Haemophilia

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Prophylactic substitution treatment and radiosynoviorthosis have a leading role in preventing irreversible haemophilic arthropathy. The aim of the study was to evaluate the effects of prophylaxis treatment and radiosynovectomy on the length of intervals between subsequent haemorrhages in haemophilic patients. Thirty-three joints were treated with radiosynovectomy in 28 patients with bleeding disorders. (90)Y colloid was used in knees and (186)Re colloid for elbows, shoulders and ankles. Twenty patients were on prophylaxis. Joint X-rays were evaluated on the Pettersson scale between 0 (normal) and 13 (severe joint destruction). During an observation period (range 6-44 months) bleeding episodes were recorded and data statistically analysed. Before radiosynovectomy, increasing intensity of the prophylaxis 10% lengthens intervals between two haemorrhages by 1% (P < 0.05). In patients with a Pettersson score higher than nine, intervals between bleedings are shorter by 73% (P < 0.05), in comparison with patients with lower Pettersson scores of 0-5. After radiosynovectomy, the length of the first non-bleeding interval increased by 120% (to 60 days) in comparison with the intervals before the procedure (P < 0.001). But, in the following year and half, every subsequent non-bleeding interval was 8% shorter (P < 0.1). In that period, prophylaxis shortened the non-bleeding interval by 1.7% (P < 0.05) per 10% increase of its intensity. Radiosynovectomy is more efficient in patients with less affected joints and is less efficient in younger patients. Prophylaxis reduced time between the bleedings episodes after isotope application. Before radiosynovectomy, prophylaxis reduces the number of haemorrhages. Our findings support data previously published by Rodriguez-Merchan et al. [J Thromb Haemost, 5 (2007) P-W-126].

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Section: Discussionmentioning

confidence: 99%

The co effect of prophylaxis and radiosynovectomy on bleeding episodes in haemophilic synovitis

Brecelj

Bole²,

Benedik-Dolničar

et al. 2008

Haemophilia

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“…The main indication for synoviorthesis is chronic hyperthrophic synovitis associated with recurrent haemarthroses. It can be performed with chemical substances such as rifamycin or rifampicin [14], osmic acid [15] and oxytetracyclin clorhydrate [16], or radioactive colloids [10]. Rifamycin and rifampicin are antibiotics used in the treatment of chronic synovitis in rheumatoid arthritis and haemophilic arthropathy [11,14].…”

Section: Discussionmentioning

confidence: 99%

Intra‐articular rifamycin in haemophilic arthropathy

et al. 2003

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Synoviorthesis is the intra-articular injection of chemical or radioactive substances able to produce fibrosis of hypertrophied synovium, which has proved effective in the treatment of chronic haemophilic synovitis. Between September 1999 and October 2001 we treated 28 outpatients (25 with haemophilia A, three with haemophilia B). Our treatment was focused on pain and functional limitation of joints. A schedule was adopted to treat each joint using intra-articular rifamycin once a week, repeated five times. Patients were covered with factor replacement on demand. Oral analgesia was offered as required because of acute but transient painful inflammatory reaction. Their median age was 34 years (range 15-60 years). The indication for synoviorthesis was chronic synovitis characterized by recurrent haemarthroses, persistent pain and limited range of motion (ROM). Thirty-five joints were treated with a total of 169 injections, including six joints (20%) in patients with inhibitors. In five patients two joints were treated in the same session. Thirty procedures were completed: 24 (80%) were considered effective (as excellent or good), while six were considered insufficient (20%). Pain was reduced in 96% of cases and in 70% the ROM was improved. In our experience intra-articular infiltration with rifamycin appears to be effective in reducing joint pain and in improving the ROM. The procedure presents a low risk of bleeding, can be used for patients with inhibitors and multiple joints can be treated without any additional cost.

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“…Osmium metal and most compounds are considered nontoxic, but the neat tetroxide of osmium is a strong oxidizer and is considered “highly toxic” in the U.S. and “very toxic” by the European Union. On the other hand, the aqueous solution, osmic acid, has been injected at ∼1% concentration in several European clinical trials, starting in the 1970s, for treatment of arthritis and hemophilia. , No toxic effects were observed. Thus, osmium toxicity might be a question not of in vivo chemistry, but of manufacture, where a concentrated form of the oxide might need to be handled …”

Section: 1 Implantable Powermentioning

confidence: 99%