For Release at 12 p.m., Sunday, Nov. 9
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Antibiotic Provides Significant Improvement in Early Rheumatoid Arthritis
An antibiotic commonly used to treat acne also provides significant improvement for people with early rheumatoid arthritis, according to a study presented at the American College of Rheumatology National Scientific Meeting Nov. 9-12 in Washington, D.C.
Rheumatoid arthritis causes pain, stiffness and swelling in many joints. This crippling disease affects more than 2 million people in the United States. Unlike osteoarthritis, the wear and tear of joints usually associated with aging, rheumatoid arthritis is an autoimmune disease which can affect the entire body at an early age. It usually strikes women between the ages of 20 and 45.
Case studies previously linked the antibiotic minocycline to improvements in rheumatoid arthritis, though two large studies in patients with long-standing disease showed the drug provided modest improvement at best. The new study from the University of Nebraska focused on patients who had rheumatoid arthritis for less than one year; the results were dramatically better.
After three years on the drug, 44 percent of the patients had improved by 75 percent or more. Improvement criteria included joint tenderness, stiffness and swelling. The study also found that those who experience significant improvement can expect their disease to flare again if therapy is stopped.
The study did not address why an antibiotic would provide such relief in a disease not commonly associated with infection. The study authors note that minocycline has been shown in other studies to inhibit metalloproteinase enzymes that break down cartilage. They believe this is an important mechanism of this drug. However, they leave open the possibility that an infectious agent is involved in the disease process.
"This study included a small number of people, so more research is necessary before we conclude that minocycline is the drug of choice for people with early rheumatoid arthritis," said James O'Dell, MD, a rheumatologist who led the study. "However, the dramatic responses seen in our patients are important, especially in light of the previous studies which suggested only modest benefit when minocycline was used in patients with established disease.
"The main difference in our study was the use of minocycline very early in disease. These findings add to an increasing body of literature suggesting early, aggressive treatment of rheumatoid arthritis with remission as a goal is the best approach. It's crucial that people who have unexplained joint pain for a month or more see their physician for evaluation and referral to a rheumatologist. If rheumatoid arthritis is treated early and aggressively, the disease can be suppressed, and patients will benefit."
The American College of Rheumatology is the professional organization for rheumatologists and health professionals who share a dedication to healing, preventing disability and curing arthritis and related rheumatic and musculoskeletal disorders.
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