rifampin and Hemorrhage

Intra-articular hemorrhage is the clinical hallmark of hemophilia. Synoviorthesis, the intra-articular injection of chemical or radioactive substances in order to produce fibrosis of the hypertrophied synovium, has proved effective in the treatment of chronic hemophilic synovitis. Between December 2006 and July 2007, we treated 21 patients with hemophilic arthropathy by synoviorthesis with rifampicin once a week. The procedures were performed on 14 knees, five elbows, four ankles, and one shoulder (24 joints and 113 injections). The mean age was 16.7 years (range, 7-49 years). According to the Fernandez-Palazzi classification, synoviorthesis was considered satisfactory (excellent or good) in 21 (87.5%) joints and unsatisfactory (fair or poor) in three (12.5%). A mean reduction of 6.3 bleeding episodes per month was obtained (P < 0.0001). The mean pain score was reduced from 2.62 (range, 2-3; SD, 0.49) before treatment to 0.79 (range, 0-2; SD, 0.65) after treatment. The mean World Federation of Hemophilia (WFH) score was 5.45 (range, 2-8) before synoviorthesis and 3.5 (range, 1-7) after treatment. This method effectively reduced hemarthrosis and pain and also improved the range of motion in patients with hemophilic arthropathy. Chemical synoviorthesis with rifampicin appears to be efficient, inexpensive, and simple and also especially practical in developing countries where radioactive agents are not easily available.

Topics: Adolescent; Adult; Child; Hemarthrosis; Hemorrhage; Humans; Joint Diseases; Middle Aged; Pain; Range of Motion, Articular; Rifampin; Synovial Membrane; Treatment Outcome; Young Adult

Anti-tuberculosis treatment can cause significant drug-drug interaction and interfere with effective anticoagulation. However, there is a lack of evidence and conflicting data on the optimal oral anticoagulation in patients treated for tuberculosis. We investigated the safety and effectiveness of anticoagulation with non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in patients on anti-tuberculosis treatment. Patients on concomitant oral anticoagulation and anti-tuberculosis treatment including rifampin were identified from the Korean nationwide healthcare database. Subjects were censored at discontinuation of either anticoagulation or rifampin. The outcomes of interest were major bleeding, death, and ischemic stroke. A total 2090 patients (1153 on warfarin, 937 on NOAC) were included. NOAC users, compared to warfarin users, were older, had a lower prevalence of hypertension, heart failure, ischemic stroke, and aspirin use and a higher prevalence of cancer, with no significant differences in CHA

Topics: Administration, Oral; Anticoagulants; Antitubercular Agents; Atrial Fibrillation; Hemorrhage; Humans; Ischemic Stroke; Rifampin; Stroke; Treatment Outcome; Warfarin

Evidence and guidelines for Non-vitamin K antagonist oral anticoagulants (NOACs) use when prescribing concurrent rifampin for tuberculosis treatment in patients with non-valvular atrial fibrillation (NVAF) are limited.. Using the Korean National Health Insurance Service database from January 2009 to December 2018, we performed a population-based retrospective cohort study to assess the net adverse clinical events (NACE), a composite of ischemic stroke or systemic embolism and major bleeding, of NOACs compared with warfarin among NVAF patients taking concurrent rifampin administration for tuberculosis treatment. After a propensity matching score (PSM) analysis, Cox proportional hazards regression was performed in matched cohorts to investigate the clinical outcomes.. Of the 735 consecutive patients selected, 465 (63.3%) received warfarin and 270 (36.7%) received NOACs. Among 254 pairs of patients after PSM, the crude incidence rate of NACE was 25.6 in NOAC group and 32.8 per 100 person-years in warfarin group. There was no significant difference between NOAC and warfarin use in NACE (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.48-1.14; P = 0.172). Major bleeding was the main driver of NACE, and NOAC use was associated with a statistically significantly lower risk of major bleeding than that with warfarin use (HR, 0.63; 95% CI, 0.40-1.00; P = 0.0499).. In our population-based study, there was no statically significant difference in the occurrence of NACE between NOAC and warfarin use. NOAC use may be associated with a lower risk of major bleeding than that with warfarin use.

Topics: Administration, Oral; Anticoagulants; Atrial Fibrillation; Hemorrhage; Humans; Retrospective Studies; Rifampin; Rivaroxaban; Stroke; Tuberculosis; Warfarin

Topics: Aged; Anticoagulants; Antitubercular Agents; Comorbidity; Cyclosporine; Drug Substitution; Drug Therapy, Combination; Female; Hemorrhage; Heparin; Humans; Immunosuppressive Agents; Kidney Transplantation; Lung Diseases, Interstitial; Pericarditis; Phenindione; Polypharmacy; Postoperative Complications; Rifampin; Sirolimus; Venous Thrombosis; Vitamin K

Totally 1427 patients with tuberculosis were investigated in Kaunas Romainiai Tuberculosis Hospital. All patients belonged to the first category (new cases positive for mycobacterium tuberculosis, or severe tuberculosis). Infiltrated and disseminated tuberculosis were the most frequent clinical forms. The frequency of infiltrated tuberculosis ranged from 57.36 to 68.8%, and disseminated tuberculosis ranged from 18.52 to 30.36%. The most frequent complications were bleeding from the lungs and chronic cor pulmonale. The resistance to isoniazid, rifampicin and streptomycin was investigated. Multi-drug resistant tuberculosis did not exceed 1%. We suggest that so few cases of multi-drug resistant tuberculosis are due to implementation of WHO treatment standards.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Antibiotics, Antitubercular; Antitubercular Agents; Child; Drug Resistance, Bacterial; Hemorrhage; Humans; Incidence; Isoniazid; Lithuania; Mycobacterium tuberculosis; Pulmonary Heart Disease; Rifampin; Streptomycin; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary; World Health Organization

Topics: Antibiotics, Antitubercular; Bronchoalveolar Lavage Fluid; Bronchoscopy; Diagnosis, Differential; Female; Hemorrhage; Humans; Legionella pneumophila; Legionnaires' Disease; Middle Aged; Rifampin; Tomography, X-Ray Computed

The anticoagulant and antithrombotic effects of YM-75466 (N-[4-[(1-acetimidoyl-4-piperidyl)oxy]phenyl]-N-[(7-amidino-2-naph thyl)methyl]sulfamoyl acetic acid monomethanesulfonate), a novel orally-active factor Xa (FXa) inhibitor, and warfarin were compared in mice. Both agents were orally administered in all studies. In ex vivo studies, the peak effects of YM-75466 occurred 1 hr after administration while the peak of warfarin activity occurred 18 hr after administration. At each peak, both YM-75466 and warfarin prolonged coagulation time dose-dependently. The dose response curve of warfarin for prothrombin time was steeper than that of YM-75466. In a thromboplastin-induced thromboembolism model, administration of 30 mg/kg YM-75466 or 3 mg/kg warfarin significantly improved the lethality ratio. In blood loss studies, YM-75466 did not increase blood loss from the tail even at 30 mg/kg, while warfarin markedly increased blood loss at 3 mg/kg. Agents that interfere with warfarin action did not interfere with YM-75466 action. In conclusion, this study shows that YM-75466 has advantages over warfarin: i) rapid onset of anticoagulant activity, ii) wide therapeutic range, iii) little effect on bleeding and iv) lack of drug interaction with agents that interfere with warfarin. These results suggest that YM-75466 may be promising as a novel oral anticoagulant agent.

Topics: Administration, Oral; Analgesics, Non-Narcotic; Animals; Anti-Bacterial Agents; Anticoagulants; Anticonvulsants; Antifibrinolytic Agents; Blood Coagulation; Carbamazepine; Cimetidine; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Interactions; Erythromycin; Factor Xa Inhibitors; Fibrinolytic Agents; Hemorrhage; Male; Mice; Mice, Inbred ICR; Partial Thromboplastin Time; Phenytoin; Piperidines; Prothrombin Time; Rifampin; Sulfonamides; Thromboembolism; Thromboplastin; Vitamin K 1; Warfarin

Topics: Anaphylaxis; Hemorrhage; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Body Weight; Drug Therapy, Combination; Ethambutol; Exanthema; Female; Fever; Follow-Up Studies; Gastrointestinal Diseases; Hemorrhage; Humans; Male; Middle Aged; Pain; Pyrazinamide; Recurrence; Rifampin; Shock; Sputum; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Antibodies; Drug Therapy, Combination; Ethambutol; Fever; Headache; Hemorrhage; Humans; Liver Function Tests; Nausea; Purpura, Thrombocytopenic; Rifampin; Time Factors; Tuberculosis, Pulmonary