People with rheumatoid arthritis have another option available to them
in their fight against the crippling autoimmune disease.
A two-year, double-blind study, conducted by researchers at the University
of Nebraska Medical Center and participants in the Rheumatoid Arthritis
Investigational Network (RAIN), compared minocycline, a common acne drug,
to hydroxychloroquine, a traditional therapy for rheumatoid arthritis.
According to the study, minocycline worked better in the early stages of
the disease with greater improvements in joint swelling, stiffness and
pain. Participants on minocycline also were more successful in tapering
or completely eliminating their use of steroids.
The study, involving 60 patients who had active rheumatoid arthritis
for less than one year, was the lead article in the October 2001 issue
of Arthritis & Rheumatism, the world’s leading journal of arthritis
and rheumatology.
“It was a very successful study,” said James O’Dell, M.D., professor
of medicine, chief of the section of rheumatology and immunology, and vice-chairman
of the department of internal medicine. “We found that there is another
option available that is extremely successful in helping patients get rheumatoid
arthritis under control with minimal toxicity.”
Rheumatoid arthritis, which causes pain, stiffness, swelling and loss
of function in the joints and inflammation in other body organs, affects
more than 2.1 million adults in the United States. Women are about two
times more likely to get it than men. The chronic disease usually strikes
in middle age, and often in the 20s and 30s. There is no cure for rheumatoid
arthritis, so the goal of treatment is to achieve remissions or near remissions.
“I can’t say enough good things about minocycline and Dr. O’Dell and
his staff. They’ve been answers to my prayers,” said Susan Kitto of Ida
Groove, Iowa, who participated in the study after being diagnosed with
rheumatoid arthritis. “I was devastated after the diagnosis because I knew
how awful I felt and thought that was how I was going to feel the rest
of my life.”
The disease made it difficult to walk or even curl her hair, Kitto said,
and eventually forced her to quit her job at a local grocery store. “I
honestly thought I would be in a wheelchair the rest of my life,” she said.
Today, the 51-year-old has her life back and is no longer on steroids.
“My whole life has changed,” said Kitto, who works as a casino security
officer. “To be truthful, I feel like I don’t have (rheumatoid arthritis)
anymore. I’m back to doing anything I want to do.”
Minocycline has been used for the past 10 years on a limited basis,
Dr. O’Dell said. The drug has seen increased usage in recent years after
two other studies showed its effectiveness is greater in the early stages
of rheumatoid arthritis and more moderate in its advanced stages.
UNMC researchers have been working to find a more effective therapy
for patients in the early stages of rheumatoid arthritis. “The idea is
to take someone with a potentially devastating disease and put them in
remission and minimize the toxicity of therapies,” Dr. O’Dell said.
RAIN is a group of rheumatologists and nurse-study coordinators across
Nebraska, Iowa, South Dakota, Minnesota, Illinois and California. Founded
in 1989, RAIN has the goal of bringing rheumatologists at UNMC together
with private practice rheumatologists who are interested in clinical study.
The RAIN home office is at UNMC.