Comparison of the Efficacy & Safety of Minocycline versus Hydroxychloroquine as an Add-On Therapy to Methotrexate in Treatment of Rheumatoid Arthritis

Objective: This study was designed to compare the efficacy and safety of minocycline versus hydroxychloroquine (hcq) as an add on therapy to methotrexate in treatment of rheumatoid arthritis. Methods: This was a prospective open label, randomized, comparative, clinical study conducted in Pt. B. D Sharma, PGIMS, Rohtak. Fifty newly diagnosed rheumatoid arthritis patients were included in the study. These were randomly assigned to one of the following treatment protocols: group one was given oral methotrexate (7.5–25 mg orally in divided doses per week), hydroxychloroquine (200mg b.d) & etoricoxib (400mg o.d). In the other group oral methotrexate (7.5–25 mg orally in divided doses per week), minocycline (100mgb.d) & etoricoxib 400mg o.d) were given. Efficacy and safety assessmentwas done by evaluation of various parameters of rheumatoid arthritis at 2, 6 & 12 wks. Repeated measures ANOVA test was applied for intragroup analysis and independent ‘t’ test was applied for intergroup analysis of various parameters. Results: In minocycline treated group, there was statistically significant improvement in most of the parameters at 12 weeks as compared to hydroxychloroquine (hcq) group except the three parameters i.e grip strength in right hand, erythrocyte sedimentation rate (esr) &health assessment questionnaire (HAQ). These three parameters although also show improvement but the difference was not statistically significant. Regarding the side effects, incidence of side effects was more with hcq group than minocycline group. Conclusion: Minocycline was found to be more efficacious and safer than hydroxychloroquine, as an add on therapy to methotrexate for the treatment of rheumatoid arthritis. © 2011 IGJPS. All rights reserved.