Question
I’ve been reading about antibiotics (minocycline, for instance) as treatment for RA. As you probably know, Kathleen Turner is taking antibiotics for her RA, and my wife had diminished symptoms when she took a “Z-pack” for a cold that turned into an infection. She’s currently on methotrexate. Can you comment on research or theory on antibiotic protocals for treatment of RA?
Answer
Antibiotics have been studied extensively over the years. Minocycline has been the most extensively studied and there are several large international studies published. It has a modest benefit in RA in the studies, but in my clinical experience, it is not very effective. With the introduction of the more effective biologic agents, interest in minocycline has diminished. The effective of minocyclcine may be due to anti-inflammatory properties rather than its anti-microbial effects. A large NIH study showed no benefit to large doses of IV antibiotics and serach for infection in the joint using PCR and other sensitive techniques was negative.
