Several patients have asked me recently about using Doxycycline for osteoarthritis treatment. One man in his fifties swore that his knee felt better when he had been taking doxycycline for rosacea. I'd also read a few press reports on the topic.
But what's the evidence? None at all according to a new Cochrane Review of the question.
The initial interest in doxycycline was triggered by pre-clinical trial data suggesting that doxycycline might act as a disease-modifying agent for the treatment of osteoarthritis, with the potential to slow cartilage degeneration.
The Cochrane reviewers found only one randomised controlled trial that compared doxycycline with placebo in 431 obese women. After 30 months of treatment, clinical outcomes were similar between the two treatment groups, with clinically insignificant changes in both pain and function in the two groups.
Significantly higher numbers of patients withdrew from the doxycycline group compared with placebo due to adverse events - some of them serious.
The researchers concluded that the symptomatic benefit of doxycycline for osteoarthritis is minimal to non-existent. There might be a very small benefit in terms of joint space narrowing but this is of questionable clinical relevance and outweighed by safety problems.
Doxycycline should not be recommended for the treatment of osteoarthritis of the knee or hip.
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