by Claire Ferguson, M.A.
When I was about 12, I started having severe acne. My mom took me to a dermatologist, and I was prescribed minocycline. It didn’t work for my acne and I had to take the next level drug, Accutane. That worked and my skin cleared up.
If you are between the ages of 20 to 55, and had acne as a teen, you too may have been prescribed minocycline for months or years to eradicate the acne. What you may not be aware of is that this drug, commonly and safely used to treat acne in teens, is also an effective treatment for rheumatoid arthritis (RA).
Shortly after I was prescribed minocycline for acne at age 12, my dad had a rapid and debilitating onset symptoms that would lead to the diagnosis of RA. Seemingly overnight, multiple joints in his hands, elbows, wrists, fingers and feet became unbearably stiff and painful. He could not walk! It was scary for me at 12, to see my dad so disabled.
As my father progressed through his medical evaluation to the eventual diagnosis of RA, my mother learned about a medical treatment that is clinically proven and is listed as an approved treatment by the American College of Rheumatology. That is the use of minocycline. Before he even saw the rheumatologist for the first time, my dad received a prescription for minocycline from our family doctor. At his first appointment with the rheumatologist, he was already feeling much better, but the x-rays did show joint damage that had already progressed. Within a few months my dad was symptom free, and he has remained in remission for more than 12 years now.
The use of minocycline for RA, also referred to as “Antibiotic Protocol,” was developed by Dr. Thomas McPherson-Brown and used successfully as early as the 1940s. In the late 1990s, the multi-center clinical trial, Minocycline in Rheumatoid Arthritis (MIRA) proved this treatment was “safe and effective.”
Severe or Long-standing Disease
Patients with severe or long-standing disease are started on a low dose of oral minocycline or doxycycline ranging, according to patient tolerance, from 50-100 mg. or tetracycline 250 mg. once daily one to two days per week. Titrated to patient tolerance the dose should be increased to a working standard dose of minocycline or doxycycline 100 mg once daily or tetracycline 250 mg. twice daily Monday, Wednesday, and Friday.
If the medication tends to aggravate the condition, it is spaced differently, maybe to once a week or twice a week, and gradually increased to the M-W-F dosage. Some patients are so highly sensitized to drugs that they can only tolerate minocycline or doxycycline 25-50 mg. once every two weeks or even once a month, but with continued titration of the dosage, it is possible to work up to the optimum standard dosage of minocycline or doxycycline 100 mg. once or twice daily, Monday, Wednesday, and Friday without flaring the disease.
Less Severe, Early Disease
For patients with less severe or early disease, the IV or IM treatment may not be required as they experience the same result using oral medication exclusively. The optimum standard dosage for these patients is minocycline or doxycycline 100 mg. once daily, Monday, Wednesday and Friday or tetracycline 250 mg. twice daily Monday, Wednesday, and Friday.
Unlike standard antimicrobial therapy, this method requires the application of new principles of drug administration with low dosage properly spaced, clinically titrated, and most often given over a long period of time.
Many rheumatologists will not tell a patient about this potential treatment, or also often will tell a patient who inquired that this treatment does not work, or that there are better options. However, with so many people continuing to suffer with the symptoms of RA, I think it is best that a patient be made aware of all medically proven treatment options.
If you would like more information on the treatment of RA with minocycline, the Road Back Foundation has helpful information to facilitate patient awareness of this “safe and effective” treatment option.