Treatment of early rheumatoid arthritis with minocycline or placebo - Results of a randomized, double-blind, placebo-controlled trial

Objective. To determine if minocgcline is an effective therapy for seropositire rheumatoid arthritis (RA) when used within the first year of disease. Methods. The Rheumatoid Arthritis Investigational Network enrolled 36 patients with RA of <1 year duration into a 6-month study of minocycline (100 mg twice daily) versus placebo, All patients were rheumatoid factor positive. The primary end point of the study was successful completion of 6 months of treatment with no drug toxicity while maintaining 50% improvement in composite symptoms of arthritis. Results. Eighteen of the 16 patients who were enrolled met 50% improvement criteria at 3 months, and maintained at least a 50% improvement for 6 months with no significant drug toxicity, Among them were 15 of the 23 patients (65%) treated with minocycline and 3 of 23 patients (13%) treated with placebo (P <0.001). Conclusion. In patients with early seropositive RA, therapy with minocycline is superior to placebo.