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Minocycline is effective for the active takayasu arteritis a matsuyama1

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1611, either, cat: 58


A Matsuyama1 , N Sakai2, M Ishigamai2, H Hiraoka2, S Yamashita2

1Osaka University Hospital, Suita, Osaka, Japan, 2Osaka University Graduate School of Medicine, Suita, Osaka, Japan
Background: Takayasu arteritis (TA) is a chronic vasculitis of large elastic arteries. A number of patients are sometimes resistance to the treatment with glucocorticoids and/or immunosuppressive agents, and not a few of them suffer drug toxicity. To evaluate the effect of minocycline in patients with active Takayasu arteritis as a novel therapy, we treated active TA patient with minocycline. Methods: Eleven patients with active Takayasu arteritis referred to Osaka University Hospital from October 2001 to July 2004 were treated with minocycline orally (100 mg, b.i.d.) for 3 months without changing the dosage of prednisolone. Clinical evaluation based on NIH Criteria of Disease Activity and assessment of erythrocyte sedimentation rate (ESR) and serum levels of C-reactive protein (CRP) were performed at baseline and after treatment. Results: A 3-month course of minocycline significantly improved disease activity score from 2.8 + 0.8 (mean + SD) to 0.7 + 1.0 (p<0.05) and inflammatory markers such as ESR (from 50 + 25 to 35 + 21 mm/h, p<0.05) and CRP (from 1.78 + 1.37 to 0.89 + 1.79 mg/dL, p<0.05), leading 9 of 11 patients to remission. Minocycline was well tolerated and no signs of toxicity were observed. Conclusion: Minocycline could be an alternative to steroids and immunosuppressive agents in patients with active Takayasu arteritis. Before our results are confirmed in controlled clinical trials, minocycline should be considered only for patients who fail to respond or are difficult to stabilize with conventional therapy.

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