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  1. Home
  3. Randomized Trial Of Longer-term Therapy For Symptoms Attributed To Lyme Disease.
  1. Home
  3. Randomized Trial Of Longer-term Therapy For Symptoms Attributed To Lyme Disease.

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Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease.

Anneleen Berende1, Hadewych J M ter Hofstede1, Fidel J Vos1

  • 1From the Departments of Medicine (A.B., H.J.M.H., F.J.V., M.L.V., M.T., B.J.K.), Medical Psychology (H.M., M.L.V., A.W.M.E.), Rheumatology (F.H.), and Health Evidence (A.R.T.D.) and the Radboud Center for Infectious Diseases (A.B., H.J.M.H., F.J.V., M.L.V., M.T., B.J.K.), Radboud University Medical Center, and Sint Maartenskliniek (F.J.V., F.H.), - both in Nijmegen, and the Health, Medical, and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden (H.M., A.W.M.E.) - all in the Netherlands.

The New England Journal of Medicine
|March 31, 2016

View abstract on PubMed

Summary
This summary is machine-generated.

Longer-term antibiotic treatment for persistent Lyme disease symptoms showed no additional benefits over shorter courses. Quality of life outcomes were similar across all treatment groups, including placebo.

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Area of Science:

  • Infectious Diseases
  • Clinical Trials
  • Bacteriology

Background:

  • Persistent symptoms attributed to Lyme disease present a controversial treatment challenge.
  • Evaluating the efficacy of extended antibiotic regimens for Lyme disease is crucial.

Purpose of the Study:

  • To assess if longer-term antibiotic therapy improves outcomes for persistent Lyme disease symptoms compared to shorter-term treatment.
  • To compare the effectiveness of doxycycline, clarithromycin plus hydroxychloroquine, and placebo in managing persistent Lyme disease symptoms.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial involving 281 patients with persistent Lyme disease symptoms.
  • Patients received 2 weeks of open-label intravenous ceftriaxone followed by 12 weeks of oral doxycycline, clarithromycin plus hydroxychloroquine, or placebo.
  • Health-related quality of life was measured using the RAND-36 Health Status Inventory (RAND SF-36) physical-component summary score.

    • Main Results:

    • No significant difference in the RAND SF-36 physical-component summary score was observed among the doxycycline, clarithromycin-hydroxychloroquine, and placebo groups at week 14 (P=0.69).
    • Quality of life scores improved significantly from baseline across all groups (P<0.001).
    • Adverse event rates were comparable across all study arms, with no serious drug-related events during the 12-week randomized phase.

    Conclusions:

    • Extended antibiotic treatment for persistent Lyme disease symptoms does not offer additional benefits for health-related quality of life beyond shorter-term interventions.
    • The study suggests that current antibiotic strategies may not significantly alter long-term quality of life in patients with persistent Lyme disease symptoms.