Treatment of early seropositive rheumatoid arthritis with minocycline: Four-year followup of a double-blind, placebo-controlled trial

James Robert O'Dell, Gail Paulsen, Claire E. Haire, Kent Blakely, William Palmer, Steven Wees, P. James Eckhoff, Lynell Warren Klassen, Melvin Churchill, Deborah Doud, Arthur Weaver, Gerald Francis Moore

Research output: Contribution to journalArticle

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Abstract

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 doubleblind 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.

Original languageEnglish (US)
Pages (from-to)1691-1695
Number of pages5
JournalArthritis and rheumatism
Volume42
Issue number8
DOIs
StatePublished - Aug 1 1999

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Minocycline
Rheumatoid Arthritis
Placebos
Antirheumatic Agents
Therapeutics
Drug Therapy
Steroids

ASJC Scopus subject areas

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

Cite this

Treatment of early seropositive rheumatoid arthritis with minocycline : Four-year followup of a double-blind, placebo-controlled trial. / O'Dell, James Robert; Paulsen, Gail; Haire, Claire E.; Blakely, Kent; Palmer, William; Wees, Steven; Eckhoff, P. James; Klassen, Lynell Warren; Churchill, Melvin; Doud, Deborah; Weaver, Arthur; Moore, Gerald Francis.

In: Arthritis and rheumatism, Vol. 42, No. 8, 01.08.1999, p. 1691-1695.

Research output: Contribution to journalArticle

O'Dell, James Robert ; Paulsen, Gail ; Haire, Claire E. ; Blakely, Kent ; Palmer, William ; Wees, Steven ; Eckhoff, P. James ; Klassen, Lynell Warren ; Churchill, Melvin ; Doud, Deborah ; Weaver, Arthur ; Moore, Gerald Francis. / Treatment of early seropositive rheumatoid arthritis with minocycline : Four-year followup of a double-blind, placebo-controlled trial. In: Arthritis and rheumatism. 1999 ; Vol. 42, No. 8. pp. 1691-1695.
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abstract = "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 doubleblind 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.",
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T2 - Four-year followup of a double-blind, placebo-controlled trial

AU - O'Dell, James Robert

AU - Paulsen, Gail

AU - Haire, Claire E.

AU - Blakely, Kent

AU - Palmer, William

AU - Wees, Steven

AU - Eckhoff, P. James

AU - Klassen, Lynell Warren

AU - Churchill, Melvin

AU - Doud, Deborah

AU - Weaver, Arthur

AU - Moore, Gerald Francis

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N2 - 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 doubleblind 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.

AB - 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 doubleblind 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.

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