WHY USE ANTIBIOTICS TO TREAT RHEUMATIC DISEASE?

A growing body of scientific evidence based on laboratory research and a significant number of clinical trials have shown that appropriate application of antibiotic therapy can have a profound effect on the course of rheumatic disease. In such leading journals as Lancet, Annals of Internal Medicine, Arthritis & Rheumatism, Rheumatology and others, antibiotics have repeatedly been proven efficacious in clinical investigations. However, because the patents have expired on the antibiotics used in these trials, there is no financial incentive to promote or explore their future use.

What Scientific and Clinical Evidence Exists?
The first study using minocycline for rheumatoid arthritis, called the NIH "MIRA" study, was completed in April 1993, and the results were reported in the Jan. 15, 1995 issue of The Annals of Medicine. The study reported that minocycline is a safe and effective treatment for rheumatoid arthritis.

Additional studies have been conducted also using minocycline.* These include two in the Netherlands by Dr. F.C. Breedveld, one in Israel by Dr. Pnina Langevitz and two at the University of Nebraska by Dr. James O'Dell. All four found significant improvement in RA with the use of minocycline. Their results have been published in internal medicine and rheumatology journals. In 1998, The Lancet published a small, open study of potentially fatal systemic scleroderma at, sponsored by The Road Back Foundation and the National Institutes of Health; two-thirds of the completers were in remission after 48 weeks of this therapy.

Today, minocycline and doxycycline (and other antibiotics as indicated) are prescribed for the various inflammatory forms of arthritis and other connective tissue diseases such as scleroderma.

Discovery of Antibiotic Treatment
The pioneer for this treatment, the late Thomas McPherson Brown was a distinguished physician, educator, and researcher who dedicated his professional life to finding the cause and cure for rheumatoid arthritis. A graduate of Johns Hopkins Medical School, after WWII, he spearheaded arthritis research for the Veterans' Administration, became Dean of Medicine at George Washington University (GWU) Medical School and a medical consultant to The White House. After retiring from GWU, he maintained a thriving clinical practice and directed the Arthritis Institute at the National Hospital just outside Washington

During his 52 years of practice, Dr. Brown treated more than 10,000 rheumatic patients with antibiotics. His outstanding success and credentials, the devotion and gratitude of patients whom he treated and have since undertaken antibiotic therapy (now continuing after his death), have been the reason this treatment has stayed in the public awareness for so many decades. There continues to be increased interest and attention to this therapeutic option as patients experience its lifesaving, life changing outcome.

Patients, who learn about the background of Dr. Brown and the success of thousands of rheumatic patients, seek out this option as a safe and effective treatment for their disease.

What is Patient Experience?
Results of a landmark 2006 online Harris Poll survey of nearly 200 eligible respondents with markers for rheumatoid arthritis (RA) or scleroderma revealed that safe and cost-effective antibiotic therapy had a clear and dramatic impact on the management of RA and improved their quality of life. Reported improvements in key markers of the disease included slowed progression of their condition (92% for antibiotic treatment versus 39% for traditional medication); decreased levels of pain (91% antibiotic treatment versus 64% traditional medication); reduced stiffness (92% antibiotic treatment versus 58% traditional medication); and reduced swelling (89% antibiotic treatment versus 58% traditional medication).

Survey respondents also reported improvements from antibiotic therapy as compared to traditional medication in regards to quality of life (94% antibiotic treatment versus 54% traditional medication); increased ability to function at home (94% antibiotic treatment versus 57% traditional medication); and reduced fatigue (93% antibiotic treatment versus 38% traditional medication). For these respondents, 78% also said that antibiotics were more tolerable to take than traditional medications.

The Harris Poll survey was an important step in qualifying real-life patient experiences and underscores the need for further research in order to better understand the potential and appropriate use of antibiotics for the broad community of rheumatic patients.

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*Other clinical trials
Gompels LL, Smith A, Charles PJ, Rogers W, Soon-Shiong J, Mitchell A, Dore C, Taylor PW, Mackworth-Young CG. J Rheumatol. 2006 Feb;33(2):224-7.Single-blind randomized trial of combination antibiotic therapy in rheumatoid arthritis.

Lai Ning-Sheng, Treatment of DMARDs- Resistant Rheumatoid Arthritis with Minocycline - A Local Experience Among the Chinese, abstract, 5th Asian Congress of Rheumatology, Manilla, January 1998

Kawanaka N, Yamamura M, Hashimoto H, Okamoto H, Morita Y, Kawashima M, Aita T, Okamoto A, Makino H, An evaluation of efficacy of minocycline as an anti-rheumatic drug in patients with active and refractory rheumatoid arthritis, Ryumachi. 1998 Dec;38(6):801-9. Department of Medicine III, Okayama University Medical School.