Doxycycline may slow osteoarthritis progress
Doxycycline slows the rate of disease progression in osteoarthritis of the knee, according to researchers.
Kenneth Brandt, Indiana University School of Medicine, Indianapolis,
and colleagues conducted a randomised controlled trial involving 431
obese women with unilateral radiographic knee osteoarthritis. Participants
received 100mg doxycycline or placebo twice daily for 30 months. Joint
space narrowing in the knee — indicative of thinning of articular
cartilage — was measured at baseline, 16 and 30 months and severity
of pain was recorded at six-monthly intervals.
The researchers found that the mean loss of joint space width at 16 months
was 40 per cent less in the doxycycline group than in the placebo group
(0.15±0.42mm vs 0.24±0.54mm; P=0.027). At 30 months it
was 33 per cent less in the doxycycline group (0.30±0.60mm vs
0.45±0.70mm; P=0.017).
The mean severity of joint pain was not reduced by doxycycline, although
the researchers note that the frequency of follow-up visits at which
participants reported a 20 per cent or greater increase in pain compared
with the previous visit was lower in the doxycycline group (P=0.004).
“In both knees, the rate of joint space narrowing was more than
twice as rapid in subjects who reported frequent increases in knee pain
as
in those with a stable pain score, appearing to validate the clinical
importance of retardation of articular cartilage loss,” say the
researchers.
They note that doxycycline did not have a significant effect on joint
space narrowing or pain severity in the opposite knee and suggest that
it may have interfered with processes driving cartilage breakdown in
the osteoarthritic knee (Arthritis & Rheumatism 2005;52:2015). |
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