Kawanaka N, Yamamura M, Hashimoto H, Okamoto H, Morita Y, Kawashima M, Aita T, Okamoto A, Makino H
Department of Medicine III, Okayama University Medical School.
Ryumachi. 1998 Dec;38(6):801-9.
The efficacy and safety of minocycline was investigated in Japanese patients with rheumatoid arthritis (RA) who had already received more than three disease modifying anti-rheumatic drugs (DMARDs). Minocycline was administered at 100 mg twice a day to fifteen patients with active RA. The drug efficacy was evaluated by the clinical variables including the number of painful and/or swollen joints, the duration of morning stiffness, grip strength, the erythrocyte sedimentation rate, serum concentrations of C-reactive protein, and the titer of rheumatoid factor. Three patients experienced adverse effects such as dizziness and abdominal pain or discomfort, but only one patient with abdominal pain and dizziness was discontinued. Fourteen RA patients, who had taken minocycline for at least 6 months, were subjected to the clinical evaluation. Among them, 8 patients (54%) showed a significant improvement of clinical valuables for disease activity, beginning even at 4 weeks of the therapy. The continued effects were observed in 8 patients with over 1 year-minocycline therapy. Intriguingly, an active patient with a history of multiple DMARDs-resistancy showed a marked favorable response to this drug. The present study indicates that minocycline may be an effective DMARD with highly safe performance for patients with active and refractory RA. This is the first demonstration of the benefit of minocycline in the Japanese patients.
在已经接受过三种以上改善病情抗风湿药物（DMARDs）治疗的日本类风湿关节炎（RA）患者中，对米诺环素的疗效和安全性进行了研究。给予15例活动性RA患者每日两次、每次100mg的米诺环素治疗。通过包括疼痛和/或肿胀关节数量、晨僵持续时间、握力、红细胞沉降率、血清C反应蛋白浓度以及类风湿因子滴度等临床变量来评估药物疗效。3例患者出现了头晕、腹痛或不适等不良反应，但只有1例因腹痛和头晕而停药。14例服用米诺环素至少6个月的RA患者接受了临床评估。其中，8例患者（54%）在治疗4周时就开始出现疾病活动度相关临床指标的显著改善。在接受米诺环素治疗超过1年的8例患者中观察到持续疗效。有趣的是，一名有多种DMARDs耐药史的活动性患者对该药物表现出明显的良好反应。本研究表明，米诺环素对于活动性和难治性RA患者可能是一种疗效显著且安全性高的DMARDs。这是米诺环素对日本患者有益的首次证明。
