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Benefit of doxycycline treatment on articular disability caused by dialysis related amyloidosis

Giovanni Montagna1, Benedetta Cazzulani, Laura Obici

  • 1Division of Nephrology and Hemodialysis, Salvatore Maugeri Foundation, IRCCS Rehabilitation Institute, Pavia, Italy.

Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis
|June 6, 2013
PubMed

Insights

Doxycycline treatment for dialysis-related amyloidosis (DRA) showed significant pain reduction and improved joint mobility in patients. This suggests doxycycline is a promising therapeutic option for managing DRA symptoms.

Area of Science:

  • Pharmacology
  • Rheumatology
  • Nephrology

Background:

  • Dialysis-related amyloidosis (DRA) is caused by beta-2 microglobulin (β2M) accumulation in patients on chronic hemodialysis.
  • Beta-2 microglobulin amyloidosis affects bones and ligaments, leading to severe joint impairment and pain.
  • Doxycycline is known to inhibit amyloid formation in vitro and accumulates in bone tissue.

Observation:

  • Three patients with severe DRA and joint pain were treated with daily doxycycline (100 mg).
  • Pharmacokinetic analysis showed drug plasma levels plateaued within one week.
  • Treatment was generally well-tolerated, with one patient discontinuing due to esophagitis.

Findings:

  • Doxycycline treatment led to significant reductions in articular pain.
  • Patients experienced measurable improvements in both passive and active joint movements.
  • Amyloid deposits, assessed by MRI, remained unchanged throughout the treatment period.

Implications:

  • Doxycycline demonstrates therapeutic potential for alleviating symptoms of dialysis-related amyloidosis.
  • The drug's ability to improve joint function and reduce pain warrants further investigation in larger trials.
  • Doxycycline may offer a viable treatment strategy for managing the debilitating effects of DRA.

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