Research Update Research Published in Lancet Introduction |
Study Recap Dr. David Trentham Study Limitations |
Minocycline is not effective in systemic sclerosis: results of an open-label multicenter trial. The degree of change in the MRSS (modified Rodnan skin thickness score) was similar to that expected in the natural course of this disease. Based on these data, minocycline is not an effective therapy for SSc. PubMed, Arthritis Rheum. 2004 Feb;50(2):553-7.
For current treatments and clinical trials for systemic sclerosis (SSc, or scleroderma), please consult a scleroderma expert or see:
Scleroderma Treatments and Clinical Trials
Scleroderma Symptoms and Treatments (Look up individual symptom pages)
Adverse Reactions Induced by Minocycline: A Review of Literature In view of the evident potential of minocycline to cause long-lasting and severe adverse effects, significant morbidity and even mortality, it should be prescribed with caution in the first-line treatment for moderate to severe acne. PubMed, Curr Drug Saf, 01/19/2021.
Case Report: Minocycline-induced polyarteritis nodosa-like vasculitis presenting as brainstem stroke. This report shows that ischemic strokes may occur as a result of minocycline-induced vasculitis. PubMed, J Clin Neurosci.
Dr. David Trentham announced the results of a Minocycline study in the treatment of diffuse Scleroderma, in Boston, Massachusetts at the International Society for Rheumatic Studies. Simultaneously, a book about it was released by Henry Scammell.
Dr. Trentham is chief rheumatologist at Beth Israel hospital in Boston. The Minocycline Study was sponsored by the Road Back Foundation and the NIH (National Institute of Health).
This study was published in "Lancet", Vol. 352, Issue 9142, on November 28, 1998.
From my reading of the book Scleroderma: The Proven Therapy That Can Save Your Life by Henry Scammell, it seems that 11 people were enrolled in the study, which used (oral) Minocycline for patients with early diffuse Scleroderma. Progress was tracked only by skin scores. Five people dropped out of the study (two died of an unrelated cancer, two had Scleroderma kidney, and two people failed protocol. Of the six who finished the study, all showed improvement in skin scores and four were considered "cured."
It was a very small sample of patients, and there was nearly a 50% failure rate in completing he study, which is very high, and two people (20%) died of Scleroderma renal failure within the first few months who had no evidence of renal disease beforehand.
This was not a double-blind test. Both the patients and the doctor knew what medication was being used. No measurements were taken of internal organ involvement. The skin scores it was based on are a purely subjective measurement. The natural course of Scleroderma is for the skin to initially harden, and then begin softening.
Many treatments have initially seemed promising for Scleroderma which in larger studies were proven to be of no benefit. The most recent example of this is Penicillamine (Depen), which was widely used for the treatment of Scleroderma in the U.S. until a large, double-blind study proved it to be of no benefit.
Hotline: Minocycline Treatment for Scleroderma. The study was sponsored in part by The Road Back Foundation and NIH. The results of this small open label study must be interpreted with extreme caution. These results do not represent a "cure" for scleroderma. American College of Rheumatology.
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