Rheumatoid knee synovitis successfully treated with intra-articular rifamycin SV.

Caruso, I; Montrone, F; Fumagalli, M; Patrono, Carlo; Santandrea, S; Gandini, M.C.

doi:10.1136/ard.41.3.232

Cited by 33 publications

(11 citation statements)

References 23 publications

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“…When clotting factor replacement has failed to prevent articular damage, patients may be eligible for procedures producing fibrosis of the synovial membrane (synoviorthesis) [1]. Rifamycin and rifampicin are antibiotics used in the treatment of chronic synovitis in rheumatoid arthritis and haemophilic arthropathy [11,14]. It can be performed with chemical substances such as rifamycin or rifampicin [14], osmic acid [15] and oxytetracyclin clorhydrate [16], or radioactive colloids [10].…”

Section: Discussionmentioning

confidence: 99%

“…During the phase of chronic synovitis (stage I/II haemophilic arthropathy according to the classification by Fernandez-Palazzi [4]), medical synovectomy (synoviorthesis) is able to decrease the frequency of bleeds due to the fact that the process is reversible at that stage [5]. Since the 1980s Caruso et al have used intra-articular rifamycin in rheumatoid arthritis [11]. Basically there are two types of synoviorthesis: chemical [7], which utilizes different substances as antibiotics, gold, osmic acid, etc., and radioactive [8][9][10], which utilizes isotopes.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intra‐articular rifamycin in haemophilic arthropathy

et al. 2003

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“…The good therapeutic response in patients with arthritides [6,7], confirmed in a recent retrospective work [8], was due to the expulsion of endosomal bioactive peptides from synovial membrane cells.…”

Section: Introductionmentioning

confidence: 92%

The role of free endosomal epitopes in the mechanisms of amelioration and flares of rheumatoid arthritis-associated conditions: pregnancy and infective hepatitis

Caruso

Caruso²,

Santandrea

et al. 2018

transl med commun

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Background: It is known that rheumatoid symptoms improve in pregnancy and in patients who develop infective jaundice. The mechanism of amelioration might involve the direct interaction of free endosomal self-epitopes that are released by the cells of the involved organ with antigen binding sites on the membranes of anti-idiotypic cells, resulting in possible suppressive effects. Methods: Immune responses of peripheral blood mononuclear cells (PBMCs) to longstanding synovial fluid (SFMC or primary ultrafiltrate) and to the endosomal extracts enriched with self-epitope-receptor microcomplexes (MICs) were investigated. The MICs (secondary ultrafiltrate) were prepared from PBMCs that were previously cultured with SFMC ultrafiltrates and had therefore been in contact with large number of self-epitopes.Results: Addition of primary ultrafiltrate to PBMCs elicited significant expansion of regulatory T cells (CTLA-4+CD4 +CD25+), and reduction of CD69+CD4+CD25+ cells. In contrast, secondary ultrafiltrate, which contains the microcomplexes, produced an inflammatory response, with CD69+ cells increasing to 47% of CD4+CD25+ cells. This opposite response indicated that, in all likelihood, the response of mononuclear cells to secondary ultrafiltrate in culture involved a subset of CD4+ T cells other than those of the primary ultrafiltrate. Conclusions: Free endosomal epitopes, released from the maternal-fetal interface and necrotic areas of diseased liver, inducing expansion of regulatory T cells, provided a type of endogenous, autonomic immunotherapy. The post-partum flare-up of the disease could be due to the sudden interruption of endogenous immunotherapy at delivery and to the inflammatory response to microcomplexes that are recognized by autoreactive T cells.

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“…Caruso et al [30] injected rifamycin SV in 15 of 30 patients with rheumatoid knee synovitis, and injected saline intraarticularly to the other 15 patients. The authors found clinical success in 14 patients in the rifamycin group, whereas persistent effusion was observed in all of the patients in the saline group.…”

Section: Discussionmentioning

confidence: 99%

Ototoxic effect of topical rifamycin SV applied in the middle ear of rats

Özbay¹,

Şahin²

2017

Kulak Burun Bogaz Ihtis Derg

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Objectives:In this study, we aimed to evaluate the ototoxic effect of topical rifamycin SV in the middle ear in a rat model. Materials and Methods:A total of 24 20-week-old adult female and eight 4-6-week-old weaned (young, post-suckling period) Wistar albino rats were used. Adult rats were separated into four groups: Group 1 (adult rifamycin), group 2 (weaner rifamycin), group 3 (gentamicin; positive control), and group 4 (saline; negative control). Before medication administration, an auditory brainstem response (ABR) test was performed on each animal under general anesthesia. Tympanic membranes of the animals were perforated, and the medications were administered to the middle ear for 10 days. Three weeks after treatment, ABR tests were repeated and pre-and posttreatment ABR threshold measurements were compared. Results:Although the mean pre-and post-treatment ABR threshold values did not significantly differ among groups 1, 2, and 4 (p>0.05), the mean post-treatment ABR threshold values were significantly higher in group 3 compared to baseline (p<0.05). Conclusion:Based on ABR measurements, the topical use of rifamycin SV, a broad-spectrum semi-synthetic antibiotic in the middle ear, does not cause hearing loss in adult or weaner rats.Keywords: Auditory brainstem response; inner ear; ototoxicity; rifamycin SV. ÖZAmaç: Bu çalışmada bir sıçan modelinde topikal rifamisin SV'nin orta kulakta ototoksik etkisi araştırıldı. Gereç ve Yöntemler:Toplamda 24 adet, 20 haftalık erişkin dişi ve sekiz adet 4-6 haftalık (sütten kesilmiş yavru) Wistar albino sıçan kullanıldı. Erişkin sıçanlar dört gruba ayrıldı; Grup 1 (erişkin rifamisin), grup 2 (yavru rifamisin), grup 3 (gentamisin; pozitif kontrol), grup 4 (salin, negatif kontrol). İlaç uygulaması öncesinde her sıçana genel anestezi altında işitsel beyinsapı yanıtı (ABR) testi uygulandı. Hayvanların timpan membranları perfore edilerek, orta kulağa 10 gün boyunca ilaçlar uygulandı. Tedaviden üç hafta sonra ABR testleri tekrar edildi ve tedavi öncesi ve sonrası ABR eşik ölçümleri karşılaştırıldı. Bulgular:Tedavi öncesi ve tedavi sonrası ortalama ABR eşik değerleri grup 1, grup 2 ve grup 4'te istatistiksel olarak anlamlı farklılık göstermez iken (p>0.05), grup 3'te tedavi sonrası ortalama ABR eşik değerleri, başlangıca kıyasla, anlamlı düzeyde daha yüksekti (p<0.05).Sonuç: İşitsel beyinsapı yanıtı ölçümlerine dayanarak, geniş spektrumlu yarı sentetik bir antibiyotik olan rifamisin SV'nin orta kulakta topikal kullanımı, erişkin veya yavru sıçanlarda işitme kaybına neden olmamaktadır.Anahtar Sözcükler: İşitsel beyinsapı yanıtı; iç kulak; ototoksisite; rifamisin SV.

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Rheumatoid knee synovitis successfully treated with intra-articular rifamycin SV.

Cited by 33 publications

References 23 publications

Intra‐articular rifamycin in haemophilic arthropathy

Intra‐articular rifamycin in haemophilic arthropathy

The role of free endosomal epitopes in the mechanisms of amelioration and flares of rheumatoid arthritis-associated conditions: pregnancy and infective hepatitis

Ototoxic effect of topical rifamycin SV applied in the middle ear of rats

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