Double blind, randomised controlled trials have shown that minocycline is an effective disease modifying antirheumatic drug (DMARD) in rheumatoid arthritis (RA), compared with placebo^1–,⁴ or hydroxychloroquine.⁵ Minocycline was first used on the premise that RA may be caused by an infection but, subsequently, it was also shown to possess other properties such as matrix metalloproteinase inhibition and immunomodulation. Despite reported proof of its efficacy, most rheumatologists do not favour the use of minocycline in RA, possibly owing to availability of other “standard” DMARDs.

We performed a retrospective review of the case notes of 28 patients with RA who were prescribed minocycline. Treatment with minocycline in these patients began before the widespread availability of biological agents. Our aim was to assess the efficacy and safety of this drug in our hands compared with published trials. Our patients included 24 …