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Tetracycline use in treating osteoarthritis: a systematic review

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Abstract

Background and aims

The purpose of the review was to synthesize the current literature regarding tetracyclines in the treatment of osteoarthritis.

Methods

Using multiple databases, a systematic review was performed with customized search terms crafted to identify studies examining doxycycline or minocycline in the treatment of osteoarthritis. Results were classified into basic science mechanistic studies, in vivo animal studies, and human clinical trials. A total of 1446 potentially relevant studies were reviewed, and after exclusion criteria were applied, 23 investigations were included in the final analysis.

Results

From 12 basic science mechanistic studies, we report on three main mechanisms by which tetracyclines may exert benefit in osteoarthritis progression: matrix metalloproteinase inhibition, immunomodulation, and nitric oxide synthase inhibition. Seven animal studies showed generally encouraging results. Four articles reported human clinical studies, showing mixed results in the treatment of osteoarthritis, potentially related to the choice of patient population, primary outcomes, and timing of treatment.

Conclusion

Tetracyclines have the potential to benefit osteoarthritis patients via multiple mechanisms. Further study is warranted to examine the optimal dose and timing of tetracycline treatment in osteoarthritis.

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Authors and Affiliations

  1. Division of Sports Medicine, Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, 740 S. Limestone, K403, Lexington, KY, 40536, USA

    Brooks N. Platt, Cale A. Jacobs, Caitlin E. W. Conley & Austin V. Stone

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  1. Brooks N. Platt
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  2. Cale A. Jacobs
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  3. Caitlin E. W. Conley
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  4. Austin V. Stone
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Contributions

CJ, CC, and AS had the original idea for the manuscript. BP performed the literature search and drafted the manuscript. BP, CC, CJ, and AS critically revised the work.

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Correspondence to Austin V. Stone.

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Platt, B.N., Jacobs, C.A., Conley, C.E.W. et al. Tetracycline use in treating osteoarthritis: a systematic review. Inflamm. Res. 70, 249–259 (2021). https://doi.org/10.1007/s00011-021-01435-4

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  • DOI: https://doi.org/10.1007/s00011-021-01435-4

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