INFO - Arthritis Today: Germ warfare: antibiotics for arthritis

[Guest guest]

Arthritis Foundation

Arthritis Today, SEPTEMBER-OCTOBER 2006

Germ Warfare: Antibiotics for Arthritis

Might antibiotics be useful for treating rheumatoid arthritis (RA), if

infections can be a trigger? Benefits have been shown, but not because of

the bacteria-fighting property of antibiotics. Instead, say experts, some

antibiotics may block cartilage-degrading enzymes called metalloproteinases.

Regardless of the specific mechanism, antibiotics often are part of RA

treatment plans.

In addition to broad-spectrum tetracycline antibiotics, including

tetracycline, minocycline and doxycycline, sulfa drugs are used. The

commonly prescribed disease-modifying anti-rheumatic drug sulfasalazine

(Azulfidine) - a combination of salicylate (the active ingredient in

aspirin) and a sulfa antibiotic - has been used for decades.

Use of antibiotics for RA started in the 1940s, when McPherson Brown,

MD, of the Rockefeller Institute in New York, began treating arthritis

patients with tetracycline after he and his colleagues discovered an

infectious microorganism in the joint fluid of RA patients - a finding that

has not been confirmed. Dr. Brown correctly concluded that antibiotics

helped RA, but he wrongly explained why the treatment worked. For the next

50 years, the medical community largely dismissed antibiotics for RA.

In 1995, however, results of a 48-week study sponsored by the National

Institutes of Health in Bethesda, Md., showed more than half of patients

taking minocycline had at least a 50-percent improvement in the number of

swollen joints and in joint tenderness. The minocycline group also showed

significant improvement in several laboratory measures of disease activity,

including blood tests such as erythrocyte sedimentation (SED) rate,

hematocrit, platelet count and rheumatoid factor levels.

Studies are continuing, although recent results have been mixed. In a study

led by Jim O'Dell, MD, at the University of Nebraska Medical Center in

Omaha, patients taking the antibiotic doxycycline along with methotrexate

fared better than those taking methotrexate alone. But a separate study,

conducted at the University of Texas Health Science Center in Houston,

failed to show a benefit for minocycline in people with scleroderma.

http://www.arthritis.org/resources/arthritistoday/2006_archives/2006_09_10/Germ_\

Warfare_p7.asp

Not an MD