Rifamycin SV Intrasiniovally Injected in Arthritides Patients Showed Anti-Synovitis Activity and Some Features of the Disease Modifying Drugs: A Clinical Approach

Objectives: We addressed retrospectively the results of polyintrasynovial infiltration with Rifamycin SV, related to 658 patients with different forms of arthritides. The objective was to verify whether this treatment, in addition to treating synovitis, had the ability to induce the remission of extrarticular signs of diseases.

Methods: The patients were subdivided according to the treatment schedule:

-The group of arthritides (374) in which patients were subjected to infiltration on only one big joint

with the aim to cure the individual synovitis;

-those (189) in whom the treatment had been extended from one to weekly infiltration of three or four big joints;

-the group of patients (95) in which only the small joints were treated.

Each of 1,364 joints, 727 big and 637 small, had been infiltrated once a week for 10 weeks and all patients were followed for three years.

Results: The individual synovitis showed a significant correlation with the kind of arthritides, the presence of radiological damage and dimension of joints. Patients in whom three or four joints were weekly infiltrated showed the remission of extra articular manifestations in psoriatic arthropathy and the clinical improvement and normalization of inflammation markers in many patients with rheumatoid arthritis. These changes occur very slowly, sometimes months after the end of 10 weeks of infiltrations.

Conclusions:The outcome of synovitis was related to anti-proliferative and cytolytic properties of Rifamycin SV. The remission of extrarticular manifestations of arthritides should be sustained by complex immunological mechanisms that Rifamycin SV indirectly might have activated only when it was infiltrated by the intrasynovial route. The therapeutic effects of intrasynovial Rifamycin SV established very slowly during and, mainly, after the end of infiltrations.