Lyme Disease Studies Fail to Clear Air

Two major studies intended to resolve controversies about the treatment of Lyme disease promise instead to raise more questions.

One study found that patients with the chronic form of the disease, when given antibiotics for three months, showed no more improvement than patients given a placebo. Lyme disease activists disputed the results, saying that the duration and kind of antibiotics given were not sufficient.

The second study looked at whether treating people bitten by a tick before they show symptoms is beneficial, and researchers found that one dose of an antibiotic was shown to have an effect. Even so, they cautioned against automatically prescribing the drug. And one Lyme disease activist, saying that a one-dose antibiotic treatment is to be preferred over the three-dose Lyme vaccine, charged that the researchers have known these results since the study was completed in 1996 and withheld the information during the vaccine’s review process.

The studies, which will be published July 12 in the New England Journal of Medicine, were released Tuesday because of their “potential importance,” the editors said.

One of the bigger controversies among Lyme researchers, doctors and patients is how to treat the condition known as chronic Lyme disease, which affects 5% to 10% of untreated patients. It can cause a range of symptoms, from persistent arthritis to neurological impairment, including memory loss, a “foggy brain,” hypersensitivity to smells and sounds, vision impairment, fatigue and partial paralysis in the face or other areas.

The Infectious Diseases Society of America recommends four weeks of oral or intravenous antibiotics. But that policy is not universally endorsed, and some doctors believe that longer treatment, sometimes taking years, is needed to get rid of the tick-borne bacteria Borrelia burdorferi.