Scleroderma Helped by Minocycline
BOSTON, Dec. 2, 2004 PRNewswire
Taking a twice daily, oral dose of the antibiotic minocycline
may be a long-awaited new treatment for the debilitating autoimmune
disease scleroderma. The findings from a one year pilot study
conducted at Beth Israel Deaconess Medical Center were published
in the November 28 issue of Lancet. "These results are highly
significant," said study leader David Trentham, Beth Israel Deaconess
rheumatologist, associate professor of medicine at Harvard Medical
"We thought the drug would lead to improvement, but to have total
clearing of the skin was quite a surprise," he said. Trentham
and his colleagues treated eleven scleroderma patients who were
in the early stages of skin disease, with an oral dose of minocycline.
Of the six patients who completed the study, four had complete
resolution of disease. The drug was well-tolerated and did not
cause any serious side effects. Trentham and his colleagues believe
that the impressive results of the pilot study warrant expanded
Physicians do not know exactly what causes scleroderma, but drugs
developed for the treatment of rheumatoid arthritis-another connective
tissue disease -- have been used successfully in some patients.
The antibiotic minocycline emerged as a likely drug candidate
when it was recently found to effectively treat rheumatoid arthritis
patients, with fewer toxic side effects than current drugs such
as penicillamine and methotrexate.
Rheumatologists do not really know why this antibiotic works,
but they do know that it has antiinflammatory properties and it
may suppress other components of the mammalian immune system,
Scleroderma afflicts 150,000 people in the United States but
there is no universally accepted treatment and physicians do not
know what starts the autoimmune processes that characterize the
disease.Fibroblasts-fiber-producing cells in the connective tissue-inexplicably
go awry, over-producing collagen which is deposited as scar tissue.
Patients suffer thickening and tightening of the skin that is
disfiguring and restricts movement. In its most severe, systemic
form scleroderma causes scarring of internal organs including
the heart, kidney and lungs that can be fatal. Large clinical
trials to test new therapies are difficult to implement due to
the rarity of the disease.
The pilot study was funded in part from The Road Back Foundation
and a grant from the National Institutes of Health. This new treatment
has also been discussed in a new book by Henry Scammel called
Scleraderma. Beth Israel Deaconess Medical Center is a major clinical,
research, and teaching affiliate of Harvard Medical School.
Source: Beth Israel Deaconess
Medical Center CO: Beth Israel Deaconess Medical Center