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Minocycline Treatment of Rheumatoid Arthritis

Harold E. Paulus, MD
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University of California, Los Angeles, School of Medicine; Los Angeles, CA 90024-1670 Requests for Reprints: Harold E. Paulus, MD, University of California, Los Angeles, School of Medicine, 1000 Veteran Avenue, 32-41, Los Angeles, CA 90024-1670.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;122(2):147-148. doi:10.7326/0003-4819-122-2-199501150-00012
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Two recent reports have created renewed interest in antibiotic treatment of rheumatoid arthritis: In this issue, Tilley and colleagues [1] report the findings of the large double-blind, placebo-controlled Minocycline in Rheumatoid Arthritis (MIRA) clinical trial; in 1994, Kloppenburg and colleagues [2] reported the results of a similar study from the Netherlands. In 1968, Sanchez [3] first reported the use of tetracycline to treat 14 patients with rheumatoid arthritis, with favorable results. McPherson-Brown and colleagues [4] also found good results in a retrospective cohort study of 98 patients with rheumatoid arthritis who were treated with antibiotics from 1978 to 1982. However, these reports were largely discounted because a 1971 double-blind study of 30 patients with rheumatoid arthritis who were randomly assigned to receive either placebo or 250 mg of tetracycline daily for 1 year failed to show any significant benefit in those receiving tetracycline therapy [5]. In two other recent open trials, patients receiving daily oral minocycline treatment showed clinical improvement [67].

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