Is Mino a DMARD??

[Airen]

I have read many times that mino is considered a DMARD for RA. Is this really the case? Or is this just a way for the FDA to approve mino as treatment for RA. I understand MTX and the biologics and the like are all DMARD’s that suppress the immune system but I was under the impression that mino does NOT suppress the immune system. Is this correct? Which is what makes it the safest treatment for RA.

Diagnosed with RA in October 2014, pain started in February 2014
Started AP in June 2015
Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

[Suzanne]

From The American College of Rheumatology:
“Minocycline also belongs to the class of drugs known as DMARDs (disease-modifying anti-rheumatic drugs).” – See more at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Minocycline-Minocin#sthash.70nkh8VL.dpuf

Mom of teen daughter with Poly JIA since age 2. Current med: azithromycin 250 mg MWF.

[jasregadoo]

This is from the link Suzanne provided:
Minocycline is an antibiotic, which means it helps stop or kill bacteria that cause infections. However, when used to treat RA, minocycline works differently to control inflammation. Minocycline decreases the production of substances causing inflammation, such as prostaglandins, metalloproteinases and leukotrienes. It also increases production of interleukin-10, a substance that reduces inflammation.

I don’t speak scientist enough to know whether that means it suppresses the immune system, but to my eyes it says no. My eyes lie to me sometimes. 😉

[Airen]

I guess I posed the wrong question. What I want to know: is minocycline an immunosuppressant?

Thanks! 🙂

Diagnosed with RA in October 2014, pain started in February 2014
Started AP in June 2015
Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

[Maz]

Airen wrote:

I guess I posed the wrong question. What I want to know: is minocycline an immunosuppressant?

Thanks!

Hi Airen,

Perhaps this link will answer your question, found in FAQ #4 on the main site?

http://www.blackwellpublishing.com/acrmeeting/abstract.asp?MeetingID=761&id=80039

“Tetracycline Antibiotics for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis” (Citation reference: Adwan, M. H. Q.; Tetracycline Antibiotics for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :406 DOI: 10.1002/art.25489)

As per the first section in this article that was presented at the American College of Rheumatology annual scientific meeting in 2009 in Philidephia:

Background:

Tetracycline antibiotics have been used in Rheumatoid arthritis (RA) since the late 1940s. Animal and in vitro studies have shown them to modify the inflammatory process in various ways unrelated to their antimicrobial activities. These include effects on matrix metalloproteinases, Nitric oxide, phospholipase A2, inflammatory cytokines, immunomodulatory Uand anti-oxidant effect as well as effects on angiogenesis, apoptosis, MAP kinases, TGF beta and poly (ADP-ribose) polymerase-1.

Immune-modulation means the alteration of some metabolic pathway in the body to effect a change in the body’s natural response. So, in the case of tetracyclines, it is modulating the inflammatory response by downregulating inflammatory cytokines, rather than causing a system-wide suppressive effect on immune response. Another effect is it’s actions with regard to MMPs (matrix metalloproteinases), meaning that it is dimishing the action of collagenase, the enzyme known to cause joint destruction. Inflammation causes free radical damage to the tissues in the human body, so the antioxidative effects of tetracyclines reduce the destructive sequalae of oxidation (oxidation is the process that causes metals to rust, so this provides a bit of a picture on this). Apoptosis means “programmed cell death” and in RA and other inflammatory diseases, normal cell death is prevented, causing damage to the tissues as the errant cells do their dirty work. Tetracyclines modify this errant response to programmed cell death, so that more normal cell functioning is restored.

[MLTelfer]

For my purposes I would not consider mino to be immunosuppressive.

[PhilC]

Not all DMARDs are immunosuppressants. I’ve seen people refer to the “immunosuppressant properties” (or similar wording) of minocycline, but I think it’s an exaggeration to say that minocycline is an immunosuppressant. I would use “anti-inflammatory properties” instead.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[lynnie_sydney]

Maz wrote:

Immune-modulation means the alteration of some metabolic pathway in the body to effect a change in the body’s natural response. So, in the case of tetracyclines, it is modulating the inflammatory response by downregulating inflammatory cytokines

I think this explains it pretty well

Be well! Lynnie

Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)

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