RA

[Guest guest]

I have been a member of this group for quite some time now, but I have

never posted a message myself. There have been many times that I have

been down, and then have read something here that has helped me to keep

on fighting and not give up.

I have been through so many medicines, enbrel, humira, methotrexate,and

now remicade. They haven't worked for me and now I have liver problems

from the methotrexate. Fortunatly I have a wonderful husband and a

terrific doctor, but still, some days the pain is so much, that I can't

help worrying that I will have to live my life on pain meds, and that

is not the way I want to live.

Still, I get up everyday and keep trying to get on with my life in

spite of my RA. Thank you for your encouragement, even if you didn't

know that I was lurking there in the background.

Sch

[Guest guest]

On another board I follow I recently

posted the following about antibiotic therapy. I think anyone who has trouble

with other medications should learn more about this and if necessary change

doctors to get one who will use it with you. It’s not for everyone and I’m

well controlled with Methotrexate and Remicade so I don’t plan on

changing. However this therapy may help others.

I have recently

learned a lot about antibiotic therapy from information supplied to me by a

friend and was surprised to learn that clinical trials show it to be as good as

or better than the most common DMARDs. Nobody seems to be pressing doctors or

patients to become informed about antibiotic therapy. I suggested to the

National Data Bank for Rheumatic Diseases that they include more in their

semiannual questionnaires about antibiotics; and in response they said that

only 4.1% of their respondents had ever tried them. They added, “It may

be that for most people Minocycline did not have a strong enough effect in the

minds of rheumatologists.” That might be true as far as what

rheumatologists think but none of the clinical trials that I have been able to

find support that opinion. I believe that if people were more informed about the

clinical trials with antibiotics that rheumatologists would be more likely to

consider it and patients would be more likely to ask their rheumatologists

about it.

There are many anecdotal stories but few clinical trials; and rheumatologists

apparently overlook the few clinical trials because nobody is actively bringing

them to the attention of rheumatologists. However, all clinical trials I have

found are favorable to antibiotics. Early clinical trials, started over 10

years ago, were with patients who had not had RA long and were against placebos

-- MIRA, O’Dell (1, 2). As a result of these clinical trials the American College of Rheumatology acknowledges

Minocycline as a DMARD for mild to moderate, early-onset RA (3). Later trials

compared antibiotics to DMARDs (4, 5, 6). Later trials also investigated

well-established RA that was resistant to some other DMARDs (7, 8, 9, 10).

I do not suggest that everyone would benefit from antibiotics and, in fact, I

am doing well on Methotrexate and Remicade and have no plans right now to add

antibiotics. However I do think antibiotics would help many people with RA.

Studies show that about half or more of the people who were not helped by other

DMARDs are helped by antibiotics. Also, because of the low relative cost of some

antibiotics, they may be available to many people who cannot afford the more

expensive DMARDs.

If anyone is interested in learning about antibiotic therapy I would be happy

to supply them with a lot of references of which I am aware. I have been helped

greatly by a friend who supplied me with most of the links I have used to learn

about antibiotics.

1. http://www.annals.org/cgi/content/full/122/2/81

Tilley MIRA 48 wks Minocycline vs placebo, 1995

2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=10446869 & dopt=Abstract

O’Dell 4 year, Minocycline vs placebo, early-onset RA, 1999

3. http://www.rheumatology.org/public/factsheets/minocycline.asp

ACR on Minocycline, updated 2006; “Minocycline is prescribed for patients

with symptoms of mild rheumatoid arthritis, sometimes in combination with other

medications to treat patients with persistent symptoms of this form of

arthritis.”

4.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=16447240 & dopt=Abstract

Doxycycline + MTX vs MTX alone, no previous DMARD, <1 year with RA, 2006

5.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=11273473 & dopt=Abstract

India

study, 6 months, Doxycycline vs MTX 6 months, 2000

6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=11665963 & dopt=Abstract

Minocycline vs Plaquenil O’Dell 2001

7.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=9592865 & dopt=Abstract

Chinese, Minocycline + unspecified DMARD, DMARD resistant before study, 1998

8.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=10047718 & dopt=Abstract

Japanese study, DMARD resistant, 1 yr, Minocycline only, 1998

9.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1334514 & dopt=Abstract

Israeli study, DMARD resistant, 48 weeks, Minocycline only

10. http://www.jrheum.com/abstracts/abstracts06/224.html

London study.

Tetracycline plus Clindamycin vs no treatment, 1 year, DMARD resistant, 2006

From: Rheumatoid Arthritis

[mailto:Rheumatoid Arthritis ] On

Behalf Of lsch99

Sent: Monday, September 25, 2006

9:45 AM

To:

Rheumatoid Arthritis

Subject: RA

I have been a member of this group for quite some time

now, but I have

never posted a message myself. There have been many times that I have

been down, and then have read something here that has helped me to keep

on fighting and not give up.

I have been through so many medicines, enbrel, humira, methotrexate,and

now remicade. They haven't worked for me and now I have liver problems

from the methotrexate. Fortunatly I have a wonderful husband and a

terrific doctor, but still, some days the pain is so much, that I can't

help worrying that I will have to live my life on pain meds, and that

is not the way I want to live.

Still, I get up everyday and keep trying to get on with my life in

spite of my RA. Thank you for your encouragement, even if you didn't

know that I was lurking there in the background.

Sch