This trial examined the safety and possible MRI and clinical effects of anti - chlamydial antibiotic therapy in relapsing- remitting MS (RRMS). Newly diagn osed MS patients were selected to participate if they showed ...This trial examined the safety and possible MRI and clinical effects of anti - chlamydial antibiotic therapy in relapsing- remitting MS (RRMS). Newly diagn osed MS patients were selected to participate if they showed Chlamydia pneumonia e gene in their CSF and had one or more enhancing lesions on brain magnetic reso nance imaging (MRI). After a 4- month run in phase of monthly MRI, patients wer e randomized to receive rifampin (300 mg twice daily) and azithromycin (500 mg e very other day) for 6 months or placebo (PBO). Patients then had monthly MRI on therapy and two additional scans on months 12 and 14. Lumbar punctures were repe ated between months 7 and 8 and within 2 weeks of termination of the study. Data on 4 patients on treatment and 4 on PBO were available for analysis. The primar y outcome measure of showing a beneficial effect on enhancing lesions was not me t. However, there was a significant difference in brain parenchymal fraction los s favoring those patient receiving antibiotics compared with PBO (p ≤ 0.02). Th ree of the four patients on antibiotic therapy cleared the organism from the CSF by month 12; in the PBO group one patient cleared the organism. The reduction i n atrophy in patients receiving antibiotics must be viewed with caution, due to the small number of patients studied.展开更多
文摘This trial examined the safety and possible MRI and clinical effects of anti - chlamydial antibiotic therapy in relapsing- remitting MS (RRMS). Newly diagn osed MS patients were selected to participate if they showed Chlamydia pneumonia e gene in their CSF and had one or more enhancing lesions on brain magnetic reso nance imaging (MRI). After a 4- month run in phase of monthly MRI, patients wer e randomized to receive rifampin (300 mg twice daily) and azithromycin (500 mg e very other day) for 6 months or placebo (PBO). Patients then had monthly MRI on therapy and two additional scans on months 12 and 14. Lumbar punctures were repe ated between months 7 and 8 and within 2 weeks of termination of the study. Data on 4 patients on treatment and 4 on PBO were available for analysis. The primar y outcome measure of showing a beneficial effect on enhancing lesions was not me t. However, there was a significant difference in brain parenchymal fraction los s favoring those patient receiving antibiotics compared with PBO (p ≤ 0.02). Th ree of the four patients on antibiotic therapy cleared the organism from the CSF by month 12; in the PBO group one patient cleared the organism. The reduction i n atrophy in patients receiving antibiotics must be viewed with caution, due to the small number of patients studied.
