Rheumatoid Arthritis Treatment
Dr Thomas McPherson Brown Protocol for treatment of Rheumatoid arthritis
(it also applies for scleroderma)
In the 1960’s, an American physician, Dr Thomas Brown, observed that some patients with rheumatoid arthritis experienced a complete clearance of their joint disease, while taking courses of tetracycline. He then replicated this effect using the same treatment in a larger number of patients with rheumatoid arthritis. The hypothesis is that some antibiotics exert a therapeutic benefit on the RA by controlling the reaction of the immune system against some bacteria such as mycoplasma. Others have postulated that different bacteria such as klebsiella or proteus mirabilis may also have a role to play (Embringer). This still remains “unproven” in day-to-day rheumatology because laboratory documentation of a “causal” link has not been made.
Articles | 15 January 1995
Minocycline in Rheumatoid Arthritis: A 48-Week, Double-Blind, Placebo-Controlled Trial
Barbara C. Tilley, PhD; Graciela S. Alarcon, MD; Stephen P. Heyse, MD, MPH; David E. Trentham, MD; Rosemarie Neuner, MD; David A. Kaplan†, MD; Daniel O. Clegg, MD; James C. C. Leisen, MD; Lenore Buckley, MD; Sheldon M. Cooper, MD; Howard Duncan, MD; Stanley R. Pillemer, MD; Marilyn Tuttleman, MS; and Sarah E. Fowler, PhD
[+] Article and Author Information
Companion Article(s): Minocycline Treatment of Rheumatoid Arthritis
Ann Intern Med. 1995;122(2):81-89. doi:10.7326/0003-4819-122-2-199501150-00001
Objective: To assess the safety and efficacy of minocycline in the treatment of rheumatoid arthritis.
Design: A double-blind, randomized, multicenter, 48-week trial of oral minocycline (200 mg/d) or placebo.
Setting: 6 clinical centers in the United States.
Patients: 219 adults with active rheumatoid arthritis who had previous limited treatment with disease-modifying drugs.
Measurements: As the primary outcomes, 60 diarthrodial joints were examined for tenderness, and 58 joints were examined for swelling (hips excluded). Grip strength, evaluator's global assessment, morning stiffness, Modified Health Assessment Questionnaire, patient's global assessment, hematocrit, erythrocyte sedimentation rate, platelet count, and IgM rheumatoid factor levels were also assessed; radiographs of both hands and wrists were taken.
Results: 109 and 110 patients were randomly assigned to receive minocycline and placebo, respectively. At entry, demographic, clinical, and laboratory measurements were similar in both groups. Most patients had mild to moderate disease activity and some evidence of destructive disease. At the week 48 visit, 79% of the minocycline group and 78% of the placebo group continued to receive the study medication. At 48 weeks, more patients in the minocycline group than in the placebo group showed improvement in joint swelling (54% and 39%) and joint tenderness (56% and 41%) (P < 0.023 for both comparisons). The minocycline group also showed greater improvement in hematocrit, erythrocyte sedimentation rate, platelet count, and IgM rheumatoid factor levels (all P values < 0.001), and more patients receiving minocycline had laboratory values within normal ranges at 48 weeks. For the remaining outcomes, P values ranged from 0.04 to 0.76, all greater than the critical value of 0.005 (Bonferroni adjustment for multiple comparisons). The frequency of reported side effects was similar in both groups, and no serious toxicity occurred.
Conclusions: Minocycline was safe and effective for patients with mild to moderate rheumatoid arthritis. Its mechanisms of action remain to be determined.
Scleroderma Minocycline Study
6 out of 11 patients with early, but severe diffuse scleroderma finished 1 year of minocycline. At the end of 1 year, 4 of the 6 had complete resolution of their skin disease and 3 of the 4 had normal patient and physician assessments. These results are significantly superior to those normally seen in drug studies for scleroderma patients. C Le, A Morales, DE Trentham, Minocycline in Early Diffuse Scleroderma, Lancet, 1998, 352:9142, pgs. 1755-1756.
For personal experiences of people who have cleared their scleroderma with antibiotic therapy
Information on clinical evidence and study reviews is also available on the website of Roadback (based in US):