One theory concerning the cause of rheumatoid arthritis is that the disease may be triggered by an infection, possibly mycoplasma, and that antibiotics can treat this disease. Minocycline, a member of the tetracycline class of antibiotics, in addition to antibacterial activity has anti-inflammatory properties, probably related to its antioxidant activity. Minocycline and other antibiotics were studied in clinical trials to treat rheumatoid arthritis.
Minocycline
In a 1995 article in the "Annals of Internal Medicine," Dr. Stephen Heyse states that in a 48-week, double-blind, placebo-controlled trial in patients with mild to moderate rheumatoid arthritis, minocycline was safe and effective. Clinical improvement in joint swelling and tenderness were evident after 12 weeks of oral monocycline 200 mg/day. At 48 weeks, more patients in the minocycline group than in the placebo group showed improvement in joint swelling--54 percent versus 39 percent, and joint tenderness--56 percent versus 41 percent, both differences statistically significant.
Doxycycline
In a 2006 article in the journal "Arthritis and Rheumatism," Dr. JR O'Dell states that a two year, double-blind study in 66 patients with early rheumatoid arthritis of less than one year's duration showed that methotrexate combined with either doxycycline at both high and low doses was more effective than methotrexate alone.
Tetracycline and Clindamycin
According to a 2006 article in "The Journal of Rheumatology," Dr. LL Gompels states that a study in 21 patients suggests that tetracycline combined with intravenous clindamycin for 12 months may provide modest benefit to patients with rheumatoid arthritis.
Roxithromycin
A 2005 study by Dr. M. Ogrendik in "MedGenMed" showed that antibodies to anaerobic bacteria that cause periodontitis are increased in the serum and synovial fluid of patients with rheumatoid arthritis. Macrolide antibiotics like roxthromycin are active against these organisms. In 2009 article in the journal "Clinical Therapeutics," Dr. M. Ogrendik states that a three month, randomized, double-blind, placebo-controlled trial in early rheumatoid arthritis patients showed roxithromycin 300 mg once-daily administered significantly improved signs and symptoms and was well tolerated.
References
- "Annals of Internal Medicine"; Minocycline in rheumatoid arthritis. A 48-week, double-blind, placebo-controlled trial. MIRA Trial Group; Dr. S. Heyse; Jan 15, 1995;122(2):81-9.
- "Clinical Therapeutics"; Efficacy of roxithromycin in adult patients with rheumatoid arthritis who had not received disease-modifying antirheumatic drugs: a 3-month, randomized, double-blind, placebo-controlled trial. M.Ogrendik; Aug 2009;31(8):1754-64.
- Riverside Online: Rheumatoid Arthritis Treatment: Can Antibiotics help?
- "The Journal of Rheumatology"; Single-blind randomized trial of combination antibiotic therapy in rheumatoid arthritis; LL Gompels; Feb 2006; 33(2):224-7.
- "Arthritis and Rheumatism"; Treatment of early seropositive rheumatoid arthritis: doxycycline plus methotrexate versus methotrexate alone; Dr. JR O'Dell; Feb 2006; 54(2):621-7.
