Does Minocycline Work in Treating RA & What are its Side Effects?

RA is an autoimmune disease, in which the immune system begins attacking the lining of the joints in the body, causing an accumulation of fluid that further leads to joint pain and inflammation throughout the body. While there are various treatment options available, more research is being conducted to find the best possible treatment for RA. Does Minocycline work in rheumatoid arthritis? Let us try to answer this question and discusses the role of Minocycline in rheumatoid arthritis.

While experts are still uncertain about what exactly causes RA, it is believed that a mix of environmental factors and genetics are behind it. Throughout much of the 20th century, doctors continued to believe that RA was caused as a result of some hidden infection, due to which they began to prescribe antibiotics for treating the condition. But, does minocycline really work in rheumatoid arthritis?

What is Minocycline?

Minocycline is a commonly prescribed antibiotic belonging to the tetracycline class of drugs. It has been in use for more than 30 years now and helps fight a host of infections. Recent studies conducted on the antibiotic have shown that it also has anti-inflammatory, neuroprotective, and immune-modulating properties. Hence, the question, does minocycline work in rheumatoid arthritis.

The group of tetracycline drugs has been used effectively since the 1960s period for treating the symptoms of rheumatoid arthritis. Minocycline is also a part of this.

However, with the advent of newer drugs, the use of minocycline has declined. Nevertheless, many research studies have shown that minocycline was very beneficial for the management of rheumatoid arthritis.

Does Minocycline Work in RA?

Does Minocycline Work in RA?

The commonest question faced by many people experiencing rheumatoid arthritis and those involved in the management of rheumatoid arthritis, is, does Minocycline work in rheumatoid arthritis. Many clinical trials and research conducted since the late 1930s have shown that there are bacteria involved in the occurrence of RA. Furthermore, controlled research studies and clinical trials of the use of minocycline for the use of RA has concluded that the antibiotic is beneficial and moderately safe for use by people suffering from RA.

Some other antibiotics have also been used for the same purpose. These include sulfa compounds, rifampicin, and other tetracyclines. However, the results have not been the same. Minocycline has been researched in many double-blind studies as well, apart from the clinical trials, due to the broad properties of this particular antibiotic.

The exact manner in which minocycline helps RA is not understood clearly. It is believed that minocycline affects nitric oxide synthase in the body, which is responsible for collagen degradation in the body. Minocycline also improves interleukin-10 in the body, which stops the production of a pro-inflammatory cytokine. The antibiotic is also known to suppress the function of B and T cells in the immune system.

Overall, minocycline is believed to have a synergistic effect, meaning it enhances the treatment of rheumatoid arthritis when it is combined with other medications or with nonsteroidal anti-inflammatory drugs (NSAIDs).

Minocycline is not approved by the US Food and Drug Administration (FDA) for use in rheumatoid arthritis (RA). This is why it is prescribed as an ‘off-label’ drug. Off-label drug use means that the medication has been approved by the FDA for one particular purpose, but has not been approved for use in a different purpose. In spite of this, a doctor can still go ahead and use the medication for the different purpose. This is the case because the FDA stringently controls the testing and approval process of drugs, but does not have a say in what purpose the drugs are being used to treat patients.

Studies Showing Benefits of Minocycline in Rheumatoid Arthritis

When considering, whether minocycline works in rheumatoid arthritis, knowing about some studies can be helpful. A meta-analysis done in 2003 at the Toronto Western Hospital of 10 studies looked at the tetracycline class of antibiotics for the treatment of rheumatoid arthritis and compared it to the use of a placebo in RA. The meta-analysis concluded that treatment with tetracycline, especially minocycline, showed clinically significant improvement in RA symptoms.

In 2001, a study was published in Arthritis & Rheumatology, which is the official journal of the American College of Rheumatology. The study had 60 participants and it compared RA treatment with minocycline to treatment with hydroxychloroquine. Hydroxychloroquine is a DMARD (disease-modifying antirheumatic drug) that is used to treat rheumatoid arthritis. The study concluded that minocycline was actually more effective than hydroxychloroquine for treating early seropositive RA.

The same research team then also did a four-year follow-up and looked at 465 patients who participated in the earlier study. This time, instead of hydroxychloroquine, the team used a placebo and minocycline. The follow-up study found that patients who were treated with minocycline had fewer remissions and also required less therapy with traditional methods. This held true even in cases who had the minocycline course of treatment only for 3 to 6 months. These studies support the fact that minocycline works in rheumatoid arthritis and can be used in its treatment.

All these studies focused on the short-term use of minocycline. After looking at many studies, late Dr. Thomas McPherson-Brown, who was a famed rheumatologist, claimed that the course of RA treatment with minocycline will start showing significant improvement within 2 to 3 years. By three years, the treatment would firmly show a stage of remission along with improvements in RA symptoms.

Are There Any Side Effects in Using Minocycline in Treating RA?

As it is believed that minocycline works in rheumatoid arthritis, it is important to understand the possible side effects. While minocycline is generally tolerated well by most people, there are some possible side effects, though they are not too severe. These include:


Minocycline, when used in the long-term, is known to significantly improve the symptoms of RA and helps put patients in remission. While it is no longer used widely today, it definitely has been proven to have benefits for RA treatment. Many studies have proved that minocycline can work in rheumatoid arthritis. However, as each case is different, your doctor would be the best judge of deciding whether or not minocycline would work in your case and if the antibiotic would benefit you.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:April 23, 2019

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