Rheumatoid arthritis: Theory proves correct

The theory that rheumatoid arthritis could be caused by a persistent Mycoplasma infection dates back to the 1950s when physicians began reporting anecdotally about their patients benefiting from treatment with tetracycline. This antibiotic, however, proved no better than a placebo in a small controlled study conducted over 20 years ago. Using an antibiotic that is more potent and more readily absorbed than tetracylcine, a new multi-center clinical trial found minocycline to be a safe and effective treatment for people with mild to moderate rheumatoid arthritis (15 January 1995).

The 229 people with rheumatoid arthritis were randomly assigned to receive either minocycline or a placebo. Most had mild to moderate disease and some evidence of joint destruction. The investigators reported, "Benefit [of minocycline] became evident at 12 weeks of therapy, and the proportion of patients treated with minocycline showing improvement continued to increase through week 48 of the study."

The standard drugs prescribed for rheumatoid arthritis can cause severe side effects and are not completely effective. While this study is clearly a breakthrough, its authors caution that long-term (beyond 48 weeks) safety and efficacy have yet to be determined.

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