O'Dell's follow up Study

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1 : Arthritis Rheum 1999 Aug;42(8):1691-5 Related Articles, Books, LinkOut

Treatment of early seropositive rheumatoid arthritis with minocycline: four-year

followup of a double-blind, placebo-controlled trial.

O'Dell JR, sen G, Haire CE, Blakely K, Palmer W, Wees S, Eckhoff PJ, Klassen

LW, Churchill M, Doud D, Weaver A, GF

Department of Internal Medicine, University of Nebraska Medical Center, Omaha

68198-3025, USA.

OBJECTIVE: Rheumatoid arthritis (RA) causes substantial morbidity and mortality,

and current treatments are suboptimal. Recent studies have demonstrated the

short-term efficacy of minocycline in the treatment of patients with early RA.

This study was undertaken to compare patients treated with conventional therapy

in the early phase of their RA and those treated with minocycline, after 4 years

of followup. METHODS: Forty-six patients with seropositive RA of <1 year's

duration had been enrolled in a double-blind study of minocycline (100 mg twice

daily) versus placebo. After the blinded portion of the study (3-6 months,

depending upon response), all patients were treated with conventional therapy.

This report compares those patients randomized to receive placebo for 3 months

and then conventional therapy for the duration of 4 years versus those

originally randomized to receive minocycline. RESULTS: Twenty of the 23 original

minocycline-treated patients and 18 of the 23 original placebo-treated patients

were available for followup (mean 4 years). At followup, RA was in remission

(American College of Rheumatology criteria) without disease-modifying

antirheumatic drug (DMARD) or steroid therapy in 8 of the patients originally

treated with minocycline compared with 1 patient in the placebo group (P =

0.02). Ten patients in the minocycline group versus 16 in the original placebo

group currently require DMARD therapy (P = 0.02). CONCLUSION: Among patients

with seropositive RA, remissions are more frequent and the need for DMARD

therapy is less in those treated early in the disease course with minocycline

compared with those treated with conventional therapy delayed by an average of

only 3 months. Minocycline appears to be an effective therapy for early RA;

further investigation into its mechanism of action is needed.

Publication Types:

a.. Clinical trial

b.. Randomized controlled trial

PMID: 10446869, UI: 99374535

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