Antibiotic Therapy for Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a painful joint disorder that is characterized by excessive swelling in the affected joints. In many cases, RA symptoms arise or worsen when a bacterial infection is present. Medical professionals have noticed that certain antibiotics that are given to RA patients who have an infection for the purpose of eliminating the infection can also have a therapeutic effect on RA symptoms (in some cases), and have specifically determined that these antibiotics work to block the activity of metalloproteinases, which are proteins that degrade cartilage. Due in part to these observations, antibiotic treatment of RA has been investigated with numerous and various antibiotic drugs. It appears that two drugs, minocycline and doxycycline, show promise as RA therapeutic agents. The candidacy of these drugs for being used for this purpose is considered in greater detail below.
More than 60 years ago, researchers at the National Institutes of Health suggested that mycoplasmas, which are a type of bacteria, may be the cause of some cases of rheumatoid arthritis. Specifically, through their studies, they believed that mycoplasma infection may trigger an immune response that is significant enough to cause joint inflammation, which is the hallmark symptom of RA. As a result of these studies, some doctors began administering the antibiotic tetracycline to their RA patients. It was reported that tetracycline treatment reduced symptoms in patients who had mild or moderate RA. However, many medical professionals remained, and many still remain, skeptical that an antibiotic treatment course can lessen RA symptoms.
Despite the skepticism that abounds in the minds of some doctors, a newer antibiotic, minocycline (which is a tetracycline-derivative), is sometimes given to those who have mild RA. There is some evidence that minocycline not only alleviates joint pain and swelling, but also slows or prevents the progression of joint damage in these individuals. Despite some reported success stories, however, more research clearly will be needed before minocycline is widely used by doctors for treating RA symptoms.
A second antibiotic agent that is sometimes used to treat RA is doxycycline, which, like minocycline, is a tetracycline derivative. The therapeutic effects of doxycycline in treating RA was first investigated about 10-12 years ago. Preliminary studies indicated that doxycycline is somewhat helpful in alleviating RA symptoms and likely reduces the rate and incidence of tissue destruction (near joints) that is typically seen in RA patients. Further, some initial studies showed that doxycycline was more effective when given in combination with methotrexate, which is a drug that has long been used to treat RA. As a result of these studies, some doctors do prescribe doxycycline, either alone or in combination with methotrexate, but doxycycline is not yet routinely prescribed by doctors in large numbers.
A Final Word
It appears that among the many antibiotics that have been investigated as potential therapeutic agents for treating RA, only two stand out: minocycline and doxycycline. However, more studies will be needed to further optimize their now marginal-to-moderate therapeutic effects. For this reason, it does not appear that antibiotic treatment of RA will be the predominant, or even a popular, option anytime soon.
This article is meant only to provide some basic background information on the current state of antibiotic therapy for rheumatoid arthritis. It is not meant in any way to contradict the good advice of your doctor.
Arthritis Today, The Arthritis Foundation, Using Antibiotics To Treat Arthritis: https://www.arthritis.org/using-antibiotics-to-treat-arthritis.php
N. Wei, When Are Antibiotics Used To Treat Arthritis?, Rheumatoid Arthritis Support: https://www.rheumatoidarthritissupport.com/article/when-are-antibiotics-used-to-treat-arthritis
J.R. O’Dell et al., Treatment of Early Seropositive Rheumatoid Arthritis: Doxcycline Plus Methotrexate Versus Methotrexate Alone, Arthritis and Rheumatism 54: 621-627 (2006).
V.R. Sreekanth et al., Doxycycline in the treatment of rheumatoid arthritis-a pilot study, Journal of the Association of Physicians in India, 48:804-807 (2000).