Treatment of early seropositive rheumatoid arthritis: A two-year, double-blind comparison of minocycline and hydroxychloroquine

James Robert O'Dell, Kent W. Blakely, Jack A. Mallek, P. James Eckhoff, Rob D. Leff, Steven J. Wees, Kelly M. Sems, Ana M. Fernandez, William R. Palmer, Lynell Warren Klassen, Gail A. Paulsen, Claire E. Haire, Gerald Francis Moore

Research output: Contribution to journalArticle

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Abstract

Objective. To compare the efficacy of minocycline with that of a conventional disease-modifying antirheumatic drug (DMARD), hydroxychloroquine, in patients with early seropositive rheumatoid arthritis (RA). Methods. Sixty patients with seropositive RA of <1 year's duration who had not been previously treated with DMARDs were randomized to receive minocycline, 100 mg twice per day, or hydroxychloroquine, 200 mg twice per day, in a 2-year, double-blind protocol. All patients also received low-dose prednisone. The primary end points of the study were 1) the percentage of patients with an American College of Rheumatology (ACR) 50% improvement (ACR50) response at 2 years, and 2) the dosage of prednisone at 2 years. Results. Minocycline-treated patients were more likely to achieve an ACR50 response at 2 years compared with hydroxychloroquine-treated patients (60% compared with 33%, respectively; P = 0.04). Minocycline-treated patients were also receiving less prednisone at 2 years compared with the hydroxychloroquine group (mean 0.81 mg/day compared with 3.21 mg/day, respectively; P < 0.01). In addition, patients treated with minocycline were more likely to have been completely tapered off prednisone (P = 0.03). Trends favoring the minocycline treatment group were seen when outcomes were assessed according to components of the ACR core criteria set, with the differences reaching statistical significance for patient's global assessment of disease activity (P = 0.004). Conclusion. Minocycline is an effective DMARD in patients with early seropositive RA. Patients treated with minocycline were more likely to achieve an ACR50 response and did so while receiving less prednisone. In addition, minocycline-treated patients were more likely to have discontinued treatment with prednisone at 2 years.

Original languageEnglish (US)
Pages (from-to)2235-2241
Number of pages7
JournalArthritis and rheumatism
Volume44
Issue number10
DOIs
StatePublished - Oct 29 2001

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Hydroxychloroquine
Minocycline
Rheumatoid Arthritis
Prednisone
Antirheumatic Agents
Therapeutics
Rheumatology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)

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Treatment of early seropositive rheumatoid arthritis : A two-year, double-blind comparison of minocycline and hydroxychloroquine. / O'Dell, James Robert; Blakely, Kent W.; Mallek, Jack A.; Eckhoff, P. James; Leff, Rob D.; Wees, Steven J.; Sems, Kelly M.; Fernandez, Ana M.; Palmer, William R.; Klassen, Lynell Warren; Paulsen, Gail A.; Haire, Claire E.; Moore, Gerald Francis.

In: Arthritis and rheumatism, Vol. 44, No. 10, 29.10.2001, p. 2235-2241.

Research output: Contribution to journalArticle

O'Dell, James Robert ; Blakely, Kent W. ; Mallek, Jack A. ; Eckhoff, P. James ; Leff, Rob D. ; Wees, Steven J. ; Sems, Kelly M. ; Fernandez, Ana M. ; Palmer, William R. ; Klassen, Lynell Warren ; Paulsen, Gail A. ; Haire, Claire E. ; Moore, Gerald Francis. / Treatment of early seropositive rheumatoid arthritis : A two-year, double-blind comparison of minocycline and hydroxychloroquine. In: Arthritis and rheumatism. 2001 ; Vol. 44, No. 10. pp. 2235-2241.
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abstract = "Objective. To compare the efficacy of minocycline with that of a conventional disease-modifying antirheumatic drug (DMARD), hydroxychloroquine, in patients with early seropositive rheumatoid arthritis (RA). Methods. Sixty patients with seropositive RA of <1 year's duration who had not been previously treated with DMARDs were randomized to receive minocycline, 100 mg twice per day, or hydroxychloroquine, 200 mg twice per day, in a 2-year, double-blind protocol. All patients also received low-dose prednisone. The primary end points of the study were 1) the percentage of patients with an American College of Rheumatology (ACR) 50{\%} improvement (ACR50) response at 2 years, and 2) the dosage of prednisone at 2 years. Results. Minocycline-treated patients were more likely to achieve an ACR50 response at 2 years compared with hydroxychloroquine-treated patients (60{\%} compared with 33{\%}, respectively; P = 0.04). Minocycline-treated patients were also receiving less prednisone at 2 years compared with the hydroxychloroquine group (mean 0.81 mg/day compared with 3.21 mg/day, respectively; P < 0.01). In addition, patients treated with minocycline were more likely to have been completely tapered off prednisone (P = 0.03). Trends favoring the minocycline treatment group were seen when outcomes were assessed according to components of the ACR core criteria set, with the differences reaching statistical significance for patient's global assessment of disease activity (P = 0.004). Conclusion. Minocycline is an effective DMARD in patients with early seropositive RA. Patients treated with minocycline were more likely to achieve an ACR50 response and did so while receiving less prednisone. In addition, minocycline-treated patients were more likely to have discontinued treatment with prednisone at 2 years.",
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T2 - A two-year, double-blind comparison of minocycline and hydroxychloroquine

AU - O'Dell, James Robert

AU - Blakely, Kent W.

AU - Mallek, Jack A.

AU - Eckhoff, P. James

AU - Leff, Rob D.

AU - Wees, Steven J.

AU - Sems, Kelly M.

AU - Fernandez, Ana M.

AU - Palmer, William R.

AU - Klassen, Lynell Warren

AU - Paulsen, Gail A.

AU - Haire, Claire E.

AU - Moore, Gerald Francis

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N2 - Objective. To compare the efficacy of minocycline with that of a conventional disease-modifying antirheumatic drug (DMARD), hydroxychloroquine, in patients with early seropositive rheumatoid arthritis (RA). Methods. Sixty patients with seropositive RA of <1 year's duration who had not been previously treated with DMARDs were randomized to receive minocycline, 100 mg twice per day, or hydroxychloroquine, 200 mg twice per day, in a 2-year, double-blind protocol. All patients also received low-dose prednisone. The primary end points of the study were 1) the percentage of patients with an American College of Rheumatology (ACR) 50% improvement (ACR50) response at 2 years, and 2) the dosage of prednisone at 2 years. Results. Minocycline-treated patients were more likely to achieve an ACR50 response at 2 years compared with hydroxychloroquine-treated patients (60% compared with 33%, respectively; P = 0.04). Minocycline-treated patients were also receiving less prednisone at 2 years compared with the hydroxychloroquine group (mean 0.81 mg/day compared with 3.21 mg/day, respectively; P < 0.01). In addition, patients treated with minocycline were more likely to have been completely tapered off prednisone (P = 0.03). Trends favoring the minocycline treatment group were seen when outcomes were assessed according to components of the ACR core criteria set, with the differences reaching statistical significance for patient's global assessment of disease activity (P = 0.004). Conclusion. Minocycline is an effective DMARD in patients with early seropositive RA. Patients treated with minocycline were more likely to achieve an ACR50 response and did so while receiving less prednisone. In addition, minocycline-treated patients were more likely to have discontinued treatment with prednisone at 2 years.

AB - Objective. To compare the efficacy of minocycline with that of a conventional disease-modifying antirheumatic drug (DMARD), hydroxychloroquine, in patients with early seropositive rheumatoid arthritis (RA). Methods. Sixty patients with seropositive RA of <1 year's duration who had not been previously treated with DMARDs were randomized to receive minocycline, 100 mg twice per day, or hydroxychloroquine, 200 mg twice per day, in a 2-year, double-blind protocol. All patients also received low-dose prednisone. The primary end points of the study were 1) the percentage of patients with an American College of Rheumatology (ACR) 50% improvement (ACR50) response at 2 years, and 2) the dosage of prednisone at 2 years. Results. Minocycline-treated patients were more likely to achieve an ACR50 response at 2 years compared with hydroxychloroquine-treated patients (60% compared with 33%, respectively; P = 0.04). Minocycline-treated patients were also receiving less prednisone at 2 years compared with the hydroxychloroquine group (mean 0.81 mg/day compared with 3.21 mg/day, respectively; P < 0.01). In addition, patients treated with minocycline were more likely to have been completely tapered off prednisone (P = 0.03). Trends favoring the minocycline treatment group were seen when outcomes were assessed according to components of the ACR core criteria set, with the differences reaching statistical significance for patient's global assessment of disease activity (P = 0.004). Conclusion. Minocycline is an effective DMARD in patients with early seropositive RA. Patients treated with minocycline were more likely to achieve an ACR50 response and did so while receiving less prednisone. In addition, minocycline-treated patients were more likely to have discontinued treatment with prednisone at 2 years.

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