Home Forums General Discussion Clinical Trials : RA & Antibiotics FOLLOW UP ?

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  • #351878
    Anonymous
    Participant

    Jan, what were the results?
    Linda

    #351879
    Suzy
    Participant

    Jan, do you have a link to those results?

    Thanks, Suzy

    #351880
    JohnnyMax
    Participant

    @Jan Lucinda1 wrote:

    This is an old study but the results were interesting.

    I have been trying to get results on this for a while myself, but came up empty. I even called NYU GI dept, but they said it was not released yet. Very interested in the Vancomycin effect, since in a previous trial, it was shown to remodel the E Coli gut bacteria in such a way as to stop the reactive arthritis it was tested on.

    Please provide a link to this info, thanks.

    John

    #351881
    Jan Lucinda1
    Participant

    The link of the trial on the first post gives the trial description with a list of publications. The first publication gives the results and conclusion.

    #351882
    Suzanne
    Participant

    @Jan Lucinda1 wrote:

    The link of the trial on the first post gives the trial description with a list of publications. The first publication gives the results and conclusion.

    Here is the link again, but it still says, “No study results posted”.

    http://clinicaltrials.gov/show/NCT01198509

    I think those abstracts came out of this trial, but I don’t think any one is the results of THE trial. Here are the publications (some have been discussed here already):
    Publications:
    Scher JU, Ubeda C, Equinda M, Khanin R, Buischi Y, Viale A, Lipuma L, Attur M, Pillinger MH, Weissmann G, Littman DR, Pamer EG, Bretz WA, Abramson SB. Periodontal disease and the oral microbiota in new-onset rheumatoid arthritis. Arthritis Rheum. 2012 Oct;64(10):3083-94. doi: 10.1002/art.34539.
    Tang W, Lu Y, Tian QY, Zhang Y, Guo FJ, Liu GY, Syed NM, Lai Y, Lin EA, Kong L, Su J, Yin F, Ding AH, Zanin-Zhorov A, Dustin ML, Tao J, Craft J, Yin Z, Feng JQ, Abramson SB, Yu XP, Liu CJ. The growth factor progranulin binds to TNF receptors and is therapeutic against inflammatory arthritis in mice. Science. 2011 Apr 22;332(6028):478-84. doi: 10.1126/science.1199214. Epub 2011 Mar 10.
    Scher JU, Sczesnak A, Longman RS, Segata N, Ubeda C, Bielski C, Rostron T, Cerundolo V, Pamer EG, Abramson SB, Huttenhower C, Littman DR. Expansion of intestinal Prevotella copri correlates with enhanced susceptibility to arthritis. Elife. 2013 Nov 5;2:e01202. doi: 10.7554/eLife.01202.
    Scher JU, Abramson SB. The microbiome and rheumatoid arthritis. Nat Rev Rheumatol. 2011 Aug 23;7(10):569-78. doi: 10.1038/nrrheum.2011.121. Review.
    Honda K, Littman DR. The microbiome in infectious disease and inflammation. Annu Rev Immunol. 2012;30:759-95. doi: 10.1146/annurev-immunol-020711-074937. Epub 2012 Jan 6. Review.
    Littman DR, Pamer EG. Role of the commensal microbiota in normal and pathogenic host immune responses. Cell Host Microbe. 2011 Oct 20;10(4):311-23. doi: 10.1016/j.chom.2011.10.004. Review.
    Brusca SB, Abramson SB, Scher JU. Microbiome and mucosal inflammation as extra-articular triggers for rheumatoid arthritis and autoimmunity. Curr Opin Rheumatol. 2014 Jan;26(1):101-7. doi: 10.1097/BOR.0000000000000008.
    Scher JU, Abramson SB. Periodontal disease, Porphyromonas gingivalis, and rheumatoid arthritis: what triggers autoimmunity and clinical disease? Arthritis Res Ther. 2013;15(5):122.

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

    #351883
    Jan Lucinda1
    Participant

    Suzanne-

    You’re right. I wonder why they haven’t been posted yet.

    #351884
    Suzanne
    Participant

    If you look at other RA trials, that is normal. A lot don’t have any results.

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

    #351885
    Maz
    Keymaster

    Although hopeful in the respect that studies are being undertaken to look at RA and microbial causes, this particular study is somewhat disappointing in that the patients in the antibiotics arm of the study were only given abx for 2 months. By comparison, MIRA ran for 48 weeks. Two months isn’t really enough time to change disease course, except to alter gut fauna and create a good herx. Patients continued being monitored after their two-month treatment with abx, but told to resume/adjust their usual RA meds as normal. No further abx are to be used after the two months as they were really just looking at changes in gut micro-fauna.

    http://www.med.nyu.edu/medicine/labs/abramsonlab/images/RA%20Brochure.pdf

    Here is a video presentation given by one of the study authors in Oct 2012, at the Langone Microbiome Center for Rheumatology and Autoimmunity (MiCRA), speaking about the microbial connection to RA. Although acknowledgment of microbial theory is dated back to the turn of the 1900s in the talk, no credit or mention is given to Brown for his later research. These researchers, however, are looking specifically at oral pathogens and not mycoplasma or any other known causative organism.

    http://medicine.med.nyu.edu/education/grand-rounds/mgr-jose-scher-md-video

    These trials are just early phase trials that seem to be trying to draw a connection to oral pathogens and RA, but not specifically to treat patients in the longer term with abx therapy. Maybe later stage studies will move in this direction? I half wonder, though, if they will be looking at ways to alter the gut microbiome of RAers in some other patent-able way. Not necessarily a bad thing. 😉

    #351886
    JohnnyMax
    Participant

    That is true, rarely do result get posted on Clinical trials. Still not in Pubmed or Journal of Rheumatology.

    The concept of using Vancomycin to remodel gut bacteria stems from the findings of its ability to not only kill off the “bad” bacteria, as do all antibiotics, but also to increase concentrations of E Coli and possibly other “good” bacteria, which is not normally an attribute of most antibiotics, they indiscriminately kill off ALL bacteria. Seems that this is what has an effect of putting the disease into remission. This is some info from a big name AP doc, now retired, that sums it up. One point, Vancomycin is extremely expensive, cost can run into the thousands of dollars for a few weeks worth.

    Further info …

    HOW ANTIBIOTICS TREAT ARTHRITIS
    May 29, 2013
    by Gabe Mirkin, MD

    Exciting new research from the University of Utrecht in the Netherlands shows how antibiotics treat arthritis.

    http://www.drmirkin.com/joints/8762.html

    RBFV Edit to remove whole article, as per forum copyright guidelines. Please only post excerpts with link to full article. Thank you for your understanding.

    #351887
    Maz
    Keymaster

    Hi Johnny,

    Sort of surprised 😮 by Mirkin (AP doc now retired) writing this in 2013, because this research was first published in 2001. This link is funky, so need to copy and paste both parts into browser without space:

    http://onlinelibrary.wiley.com/doi/10.1002/1529-0131(200011)

    43:11%3C2583::AID-ANR28%3E3.0.CO;2-U/full

    LLMDs have been using vancomycin and flagyl for a long time to treat rheumatic manifestations of Lyme and Arthritis Trust advocates for the use of nitroimidazoles, such as flagy and tinidazole for RA and other rheumatic diseases in long pulses. Also used in CPn Help protocols.

    Interesting findings by the Dutch researchers re: e-coli! Mirkin also has an article on his site that “used” to include e-coli (causes a lot of UTIs) as a cause of reactive arthritis. I wonder if he’s edited this infection out now?

    http://www.drmirkin.com/joints/j159.html

    http://en.wikipedia.org/wiki/Escherichia_coli#Role_in_disease

    #351888
    Robert
    Participant

    Hi all

    wished i could take part in this study,,as previously stated i have had infections all my life which certainly involved my teeth,,,always had abcesses, had them all out at 27 ,,,but the lung interest me more as thinking back i believe i have had infections there more often than not unbeknown to me at that time,,,i dont know if you guys have had more than your fair share of infections while growing up,but in my case i had them every year sometimes twice a year,this is why i have no doubt that infections are a major trigger for RA.,,mainly because it makes sense,,you have to go with logic if there is no other reason,,possible other factors in r.a.are also involed ,however i believe the infectious cause is more plausible, well cartainly in my case,,,has anyone else had infections while growing up?,,lungs,sinus,tonsils,etc?,,,,any feedback is most welcome.Robert.

    #351889
    lemons
    Participant

    Hello Robert in response to your query about infections while growing up , yes I had many. I suffered often with tonsillitis throughout childhood. About six years ago I had a weeping sore in my nostril ( revolting I know and the reason why I don’t have a profile picture on this forum, as I then would feel I couldn’t share this vomit inducing info with the world ) my GP said it was some form of strep and that I was a carrier. Apparently about a 3rd of the population is. The incident that I am convinced triggered my RA happened back in 2011. I had an impacted wisdom tooth extracted that had become infected. Afterwards I could still feel a sharp shard of what I knew was a piece of tooth that had broken off during extraction. I kept going back to my dentist but he said it was bone and it would settle down. Nine months later the gum line around the site of the extraction was infected, an X ray concluded that there was some remaining tooth still left in the socket. I was referred to my local hospital where I spent a memorable hour having the thing removed. Twelve months later I experienced my first ever RA flare. I read an article not so long ago about a woman with arthritis. It was from papers written by a doctor back in 1912. He claimed that she also had severe tooth decay and he had removed every single tooth from the womans head. Afterwards he observed that some time later, the womans arthritis seemed to have vanished !

    #351890
    Trudi
    Participant

    I also had a lot of tonsilitis as a kid.
    Trudi

    Lyme/RA; AP 4/2008 off and on to 3/2010; past use of quinolones may be the cause of my current problems, (including wheelchair use); all supplements (which can aggravate the condition) were discontinued on 10/14/2012. Am now treating for the homozygous MTHFR 1298 mutation. Off of all pain meds since Spring '14 (was on them for years--doctor is amazed--me too). Back on pain med 1/2017. Reinfected? Frozen shoulder?

    #351891
    mary77
    Participant

    Robert,
    Put me in that category of a lot of tonsilitus as a child! Also, when I was in my young 20s, I developed bronchitis. I did not have health insurance, so was able to pay for one doctor’s visit. He didn’t treat me with an antibiotic. I could not afford to go back for another visit, so suffered with bronchitis symptoms for 2 months. Every winter for the next 5+ years, I had bronchitis. It was treated but only the tetracyclines worked. I have to believe that it was either mycoplasma pneumonia or chlamydia pneumonia (or both) that caused the illness. I have tested very positive for both! A deer tick bite was then “acquired” several years later…and the Lyme/RA became deeply entrenched with no diagnosis or treatment for 10 years.
    So do I believe in the “infectious” theory of these illnesses? YES!!
    Mary

    #351892
    Dunlop321
    Participant

    Hi

    I also believe that an infection can trigger RA.
    I suffered lots from strep throat as a teenager. I also remember getting a really really bad flu about 6 months before I noticed pains in my feet and knees, which was the onset of RA.

    Furthermore my Dad stepped on a nail, got and infection in his bone took masses of antiobic to clear the infection. Few months later he got hit with RA. He has never been in hospital before that. All at age 70.

    Personally I think RA remains a sleeper defect in a lot of people. It needs a trigger to get going.

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