INFO - DrDoc Online: Minocycline in the treatment of RA

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Minocycline in the treatment of rheumatoid arthritis

They have been many theories of an infective cause for rheumatoid

arthritis. These have included Epstein Barr virus, mycoplasma, rubella

virus, parvovirus, and many other claimed agents. For many years,

minocycline and the tetracyclines were advocated for treatment of rheumatoid

arthritis by McPherson Brown. The studies done by Brown however

received much criticism because of study methods and protocol.

Studies were poorly controlled and much of the data unsubstantiated.

However more recently, studies have been performed looking at

tetracyclines in rheumatoid arthritis.

The tetracyclines have many potential influences against rheumatic

disease.

1. An immunomodulating action by inhibition of chemotaxis, lymphocyte

proliferation and differentiation.

2. An anti-bacterial activity / antiviral activity.

3. An Anti-inflammatory activity with inhibition of metalloproteinases.

Most studies now show minocycline to have some efficacy in rheumatoid

arthritis when compared to placebo. These results do not show definite

difference in preventing disease progression.

The minocycline in rheumatoid arthritis study (Tilley et al. ls of

Internal medicine: volume 122 No. 2, Jan. 1995, pp. 81 to 89.), 109 patients

on minocycline were compared to 110 patients on placebo. Patients are

studied over 48 weeks. There is an improvement in joint swelling of 54

percent versus 39 percent. There was improvement in joint tenderness-56

percent versus 41 percent with no serious toxicity.

The conclusion was that minocycline was a safe effective treatment for

patients with mild to moderate rheumatoid arthritis.

The side effect profile of minocycline include:

nausea

dizziness

skin rash

headaches

interstitial nephritis

acute hepatic injury

lupus like syndrome

photo sensitivity

dermatitis

The usual dose of minocycline in the studies was 100 mg twice daily.

Further studies are required to confirm the place of minocycline in

the management of Rheumatoid arthritis.

My personal feeling is that it has an efficacy comparable to

hydroxychloroquine, and is best used in mild disease.

http://www.arthritis.co.za/minocycline_in_tra.htm

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org