Method for treatment of reactive arthritis or bursitis

An improved method for treatment of conditions in human beings associated with either or both reactive arthritis or bursitis comprising administration of a combination of L-lysine, minocycline hydrochloride, isonicotinic acid hydrazide, and metronidazole.

BACKGROUND OF THE INVENTION 
This invention relates to an improved treatment for symptoms associated in 
humans with reactive arthritis or idiopathic bursitis. 
Reactive arthritis refers to a spondyloarthritity which usually arises as a 
complication of an infection elsewhere in the bodye. Reactive arthritis 
can be caused by species of Shigella bacteria (most notably Shigella 
flexneri), Yersinia enterocolitica, Campylobacter jejuni, several species 
of Salmonella, genitourinary pathogens, Chlamydia trachomatis, Neisseria 
gonorrhoeae, and Ureaplasma urealyticum, and Streptococcus pyogenes, and 
other yet unidentified infectious agents. 
Reactive arthritis commonly occurs in young men and women, but can occur at 
any age. Sufferers experience joint pain, stiffness, redness or swelling. 
Common symptoms may include a fatigue, malaise, fever, and weight loss. 
The joints of the lower extremities, including the knee, ankle, and joints 
of the foot, are the most common sites of involvement, but symptoms can 
also occur in the wrists, fingers, elbows, shoulders, neck, and lower 
back. Other symptoms may include urethritis and prostatitis in males, and 
cervicitis or salpingitis in females. Ocular disease is common ranging 
from transient, asymptomatic conjunctivitis to aggressive anterior uveitis 
that occasionally results in blindness. Mucocutaneous lesions and nail 
changes are frequent. On less frequent or rare occasions manifestations of 
reactive arthritis include cardiac conduction defects, aortic 
insufficiency, central or peripheral nervous system lesions, and 
pleuropulmonary infiltrates. 
Treatment of patients suffering from reactive arthritis with nonsteroidal 
anti-inflammatory drugs ("NSAID") provides some benefit, although symptoms 
of reactive arthritis are rarely completely alleviated and some patients 
fail to respond at all. The preferred initial treatment of choice for 
acute reactive arthritis is indomethacin in divided doses of 75 to 150 
milligrams per day. The NSAID of last resort is phenylbutazone, in doses 
of 100 milligrams twice or three times per day, because of its potentially 
serious side effects. Patients with debilitating symptoms refractory to 
NSAID therapy may be treated with cytotoxic agents such as azathioprine or 
methotrexate, or with sulfaxalizine. Tendinitis, other lesions, and 
uveitis may benefit from corticosteroids. Minocycline hydrochloride, a 
semisynthetic derivative of tetracycline, is indicated for infections 
caused by at least Shigella microorganisms, Streptococcus pyogenes, and 
Neisserie gonorrhoeae. It is therefore an accepted treatment in incidents 
of reactive arthritis triggered by these biological entities. 
Long-term follow-up studies have suggested that some joint symptoms persist 
in many, if not most, patients with reactive arthritis. Recurrences of the 
more acute symptoms are common and as many as twenty-five percent of 
patients either become unable to work or are forced to change occupations 
because of persistent joint problems. 
Bursitis is inflammation of a bursa, a thin-walled sac lined with synovial 
tissue. The function of the bursa is to facilitate movement of tendons and 
muscles over bony prominences. Bursitis may be caused by excessive 
frictional forces, trauma, systemic disease such as rheumatoid arthritis 
or gout, or infection. The most common form of bursitis is subacromial. 
Trochanteric bursitis causes patients to experience pain over the lateral 
aspect of the hip and upper thigh, and tenderness over the posterior 
aspect of the greater trochanter. Retrocalcaneal bursitis involves the 
bursa located between the calcaneus and the posterior surface of the 
Achilles tendon. Pain is experienced at the back of the heel, and swelling 
appears on either or both of the medial and lateral sides of the tendon. 
Retrocalcaneal bursitis occurs in association with spondyloarthritities, 
rheumatoid arthritis, gout, and trauma. 
Treatment of bursitis generally consists of prevention of the aggravating 
condition, rest of the involved part, an NSAID, and local steroid 
injection. In the long term, bursitis can result in loss of use of ajoint 
and chronic pain syndrome. 
The long term effects of reactive arthritis and bursitis range from chronic 
pain to crippling disability. It is also thought that many instances of 
osteoarthritis are in actuality reactive arthritis. Unfortunately, current 
procedures for management treat the symptoms of these diseases rather than 
their underlying pathogens. 
SUMMARY OF THE INVENTION 
The inventor has discovered that significant benefits can be obtained by 
treating humans affected with conditions associated with reactive 
arthritis or bursitis using combinations of L-lysine, minocycline 
hydrochloride, isonicotinic acid hydrazide (commonly referred to as InH), 
and metronidazole. 
L-lysine has been shown to inhibit the growth of herpes virus cultures and 
can be effective in alleviating the symptoms associated with herpes 
infections, both oral and genital. 
Minocycline is a bacteriostatic antibiotic which exerts its antimicrobial 
effect by inhibition of bacterial protein synthesis. It has been shown to 
be effective against gram-negative bacteria, some gram-positive bacteria 
and other microorganisms. 
InH is known to act against actively growing tubercle bacilli. Heretofore, 
InH has been indicated for treatment of pulmonary tuberculosis. Adults 
with high doses of InH sometimes are observed to have a deficiency of 
pyridoxine hydrochloride. Appropriate doses of pyridoxine hydrochloride 
are therefore administered to patients being treated with InH. 
Metronidazole is an oral synthetic antiprotozoal and antibacterial agent. 
Heretofore it has been indicated for treatment of symptomatic 
trichomoniasis, intestinal amebiasis, and a wide range of intra-abdominal, 
skin, and gynecological, bone and joint, and lower respiratory tract and 
central nervous system infections, bacterial septicemia and endocarditis. 
The method of treatment of the invention puts the diseases of reactive 
arthritis and bursitis into remission. The treatment may effect a cure of 
reactive arthritis and bursitis, but definitive testing has not been 
performed to confirm that it effects a cure. 
The basic method of treatment with L-lysine, minocycline hydrochloride, 
InH, and metronidazole, may be supplemented with pyridoxine hydrochloride, 
glucosamine, manganese, vitamin C, and desalinated seawater, such as 
Essence of Life. 
It is therefore a primary object of the invention to provide a method of 
treatment for conditions in human beings associated with either or both 
reactive arthritis or idiopathic bursitis. It is another object of the 
invention to provide a method for treatment of conditions in human beings 
associated with either or both reactive arthritis or idiopathic bursitis 
that puts the disease being treated into full remission. 
DETAILED DESCRIPTION OF THE INVENTION 
A method for treatment of the symptoms in human beings of reactive 
arthritis or idiopathic bursitis, or both, comprises the administration of 
the combination of L-lysine, minocycline hydrochloride, InH, and 
metronidazole. Administration will generally be accomplished orally, but 
delivery could be accomplished by injection, or any other method commonly 
used for administration of internal medicines. 
The preferred dosage of L-lysine is 2 grams daily. The daily dose of 
L-lysine may vary from 1 to 10 grams. 
The preferred dose of minocycline hydrochloride is an initial dosage of 200 
mg followed by doses of 100 mg twice per day. Daily doses of minocycline 
hydrochloride following the initial administration of 200 mg may vary from 
50 mg to 200 mg. 
The preferred dose of InH in an adult is 300 mg per day and is usually 
reserved for those individuals who have tested positively for 
microbacterial exposure. Accordingly, InH is administered only in those 
individuals for whom it is indicated. The daily dose of InH may vary from 
50 mg to 300 mg. 
The preferred dose of metronidazole is 250 mg four times per day. The total 
dose per day of metronidazole may vary from 100 mg to 1,000 mg. 
The combination of minocycline hydrochloride, InH, and metronidazole 
inhibits the multiplication of susceptible organisms, including shigella, 
salmonella, chlamydia, streptococci, and mycobacteria. L-lysine inhibits 
the growth of herpes symplex viruses. The total combination of medicines 
presents a broad spectrum approach that it is believed for the first time 
effectively addresses the underlying pathogenisis for reactive arthritis 
and what has previously been referred to as idiopathic bursitis.

EXAMPLES 
The following examples serve to illustrate the invention, but are not meant 
to restrict the effective scope of the invention. 
Example 1 
An adult male presented with symptoms involving his knees, ankles, elbows, 
wrist and carpophalengeal joints. Stooping activities caused severe pain 
in his knees. Simple driving activities caused pain in his elbows, wrists, 
and knees. He was unable to run or jog because of pain in his knees and 
ankles. Lifting objects weighing more than five pounds caused wrist and 
hand pain. The patient was treated with metronidazole and minocycline 
hydrochloride for thirty days and simultaneously with L-lysine and InH for 
one year. Positive symptomatic relief was achieved within two weeks of 
treatment with the combination of metronidazole, minocycline 
hydrochloride, InH, and L-lysine, with complete recover at the end of the 
course of treatment with InH. The patient has continued taking L-lysine 
because of the probable idiologic role of herpes symplex and its tendency 
to remain present in a dormant. The patient now has no problems lifting, 
running or driving. However, it should be kept in mind that infections can 
reoccur and treatment with at least minocycline hydrochloride and 
metronidazole may be necessary again. 
Example 2 
A seventy-one year old female suffered from reactive arthritis and had 
symptoms of joint pain and stiffness involving her knees, wrists, elbows, 
and hips. Pain in multiple joints caused difficulty walking, arising from 
a sitting position to a standing position, and sitting down from a 
standing position. The patient was unable to run or jog. The patient was 
treated with metronidazole and minocycline hydrochloride for thirty days 
and simultaneously with L-lysine and InH for one year. Treatment effected 
resolution of all joint pains. After treatment the patient was able to 
walk without pain, to arise from a sitting position, and to sit down from 
a standing position without difficulty. This patient was also able to jog 
without discomfort or difficulty. 
No adverse side effects have been observed as a result of or during the 
above described treatment. In the cases tested, the treatment resulted in 
a dramatic elimination of symptoms of the disease being addressed. 
There have been thus described certain preferred embodiments of a method 
for treatment of conditions in human beings associated with either or both 
reactive arthritis or idiopathic bursitis. While preferred embodiments 
have been described and disclosed, it will be recognized by those with 
skill in the art that modifications are within the true scope and spirit 
of the invention. The appended claims are intended to cover all such 
modifications.