Comparison of Doxycycline and Azathioprine in the treatment of active rheumatoid arthritis

Background: Therapeutic effects of Azathioprine (AZA) and Doxycycline (DOX) on arthritis
Rheumatoid (RA) patients have been recognized. However, there is not much information available
about the difference of their effects in the treatment of RA.
Methods and Materials: Seventy-one patients finished 16 weeks of the study. (32 patient in AZA and
39patients in DOX group). All patients received less than 10 mg/day prednisolone. Group 1 and 2
received 50 mg AZA and 100mg DOX twice in day respectively. We evaluated clinical (tender &
swollen joint counts, Ritchi articular index, morning stiffness, pain score (VAS), gripe strength) and
laboratory measurements (hemoglobin, platelets counts, WBC, ESR, CRP, RF) and physician overall
assessment.
Results: At entry, demographic, clinical and laboratory measurements were similar in both
groups. At 16th week both groups showed statistically significant improvement in clinical and
laboratory measurements. There were no statistically significant differences between the treatment
groups in clinical and laboratory variables (P<0.05) except for ESR and CRP that were better
improvement in AZA group (P<0/001,P<0/01respectively). Minor adverse effects (Gastrointestinal,
skin) were more frequent in DOX group, but withdrawals because of sever adverse effects were
similar in both groups.
Conclusions: Therapeutic effects of DOX and AZA on arthritis Rheumatoid patients were alike and
there was not significant difference in clinical and laboratory variable of illness recovery as well as
overall evaluation of the two drugs, but side effects of DOX were more than those of AZA.