Role of Doxycycline as an Osteoarthritis Disease-Modifying Drug
Doxycycline is a drug that has been proposed to modify osteoarthritis (OA) progression, in addition to its role as an antibiotic. However, available evidence thus far comprises sporadic reports, with no consensus on its benefits. Hence, this review attempts to analyze the evidence available thus far...
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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/8/2927 |
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| author | Saseendar Shanmugasundaram Ketansinh Solanki Samudeeswari Saseendar Vijay K. Chavada Riccardo D’Ambrosi |
| author_facet | Saseendar Shanmugasundaram Ketansinh Solanki Samudeeswari Saseendar Vijay K. Chavada Riccardo D’Ambrosi |
| author_sort | Saseendar Shanmugasundaram |
| collection | DOAJ |
| description | Doxycycline is a drug that has been proposed to modify osteoarthritis (OA) progression, in addition to its role as an antibiotic. However, available evidence thus far comprises sporadic reports, with no consensus on its benefits. Hence, this review attempts to analyze the evidence available thus far on the role of doxycycline as a disease-modifying osteoarthritis drug (DMOAD) in knee osteoarthritis. The earliest evidence of doxycycline in OA appeared in 1991 when doxycycline was found to inhibit the type XI collagenolytic activity of extracts from the human osteoarthritic cartilage, and gelatinase and tetracycline were found to inhibit this metalloproteinase activity in articular cartilage in vivo, which could modify cartilage breakdown in osteoarthritis. Apart from the inhibition of cartilage damage by metalloproteinases (MMPs) and other cartilage-related mechanisms, doxycycline also affects the bone and interferes with many enzyme systems. The most significant finding after reviewing various studies was that doxycycline has a definitive role in structural changes in osteoarthritis progression and radiological joint space width, but its role in the improvement of clinical outcomes as a DMOAD has not been established. However, there is much of a gap and lack of evidence in this regard. Doxycycline, as an MMP inhibitor, has theoretical advantages for clinical outcomes, but the present studies reveal only beneficial structural changes in osteoarthritis and very minimal or nonexistent advantages in clinical outcomes. Current evidence does not favor the regular use of doxycycline for the treatment of osteoarthritis as an individual treatment option or in combination with others. However, multicenter large cohort studies are warranted to determine the long-term benefits of doxycycline. |
| first_indexed | 2024-03-11T04:53:04Z |
| format | Article |
| id | doaj.art-897af6812a1c4f8bb4ac790afb54366e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:53:04Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-897af6812a1c4f8bb4ac790afb54366e2023-11-17T19:50:25ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01128292710.3390/jcm12082927Role of Doxycycline as an Osteoarthritis Disease-Modifying DrugSaseendar Shanmugasundaram0Ketansinh Solanki1Samudeeswari Saseendar2Vijay K. Chavada3Riccardo D’Ambrosi4Sri Lakshmi Narayana Institute of Medical Sciences, Chennai 605502, IndiaBankers Group of Hospital, Vadodara 390007, IndiaSri Lakshmi Narayana Institute of Medical Sciences, Chennai 605502, IndiaDepartment of Community Medicine, Indira Gandhi Medical College and Research Institute, Puducherry 605009, IndiaIRCCS Ospedale Galeazzi—Sant’Ambrogio, 20161 Milan, ItalyDoxycycline is a drug that has been proposed to modify osteoarthritis (OA) progression, in addition to its role as an antibiotic. However, available evidence thus far comprises sporadic reports, with no consensus on its benefits. Hence, this review attempts to analyze the evidence available thus far on the role of doxycycline as a disease-modifying osteoarthritis drug (DMOAD) in knee osteoarthritis. The earliest evidence of doxycycline in OA appeared in 1991 when doxycycline was found to inhibit the type XI collagenolytic activity of extracts from the human osteoarthritic cartilage, and gelatinase and tetracycline were found to inhibit this metalloproteinase activity in articular cartilage in vivo, which could modify cartilage breakdown in osteoarthritis. Apart from the inhibition of cartilage damage by metalloproteinases (MMPs) and other cartilage-related mechanisms, doxycycline also affects the bone and interferes with many enzyme systems. The most significant finding after reviewing various studies was that doxycycline has a definitive role in structural changes in osteoarthritis progression and radiological joint space width, but its role in the improvement of clinical outcomes as a DMOAD has not been established. However, there is much of a gap and lack of evidence in this regard. Doxycycline, as an MMP inhibitor, has theoretical advantages for clinical outcomes, but the present studies reveal only beneficial structural changes in osteoarthritis and very minimal or nonexistent advantages in clinical outcomes. Current evidence does not favor the regular use of doxycycline for the treatment of osteoarthritis as an individual treatment option or in combination with others. However, multicenter large cohort studies are warranted to determine the long-term benefits of doxycycline.https://www.mdpi.com/2077-0383/12/8/2927doxycyclineosteoarthritisMMPskneehip |
| spellingShingle | Saseendar Shanmugasundaram Ketansinh Solanki Samudeeswari Saseendar Vijay K. Chavada Riccardo D’Ambrosi Role of Doxycycline as an Osteoarthritis Disease-Modifying Drug Journal of Clinical Medicine doxycycline osteoarthritis MMPs knee hip |
| title | Role of Doxycycline as an Osteoarthritis Disease-Modifying Drug |
| title_full | Role of Doxycycline as an Osteoarthritis Disease-Modifying Drug |
| title_fullStr | Role of Doxycycline as an Osteoarthritis Disease-Modifying Drug |
| title_full_unstemmed | Role of Doxycycline as an Osteoarthritis Disease-Modifying Drug |
| title_short | Role of Doxycycline as an Osteoarthritis Disease-Modifying Drug |
| title_sort | role of doxycycline as an osteoarthritis disease modifying drug |
| topic | doxycycline osteoarthritis MMPs knee hip |
| url | https://www.mdpi.com/2077-0383/12/8/2927 |
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