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Pilot Study of Minocycline in Relapsing-Remitting Multiple Sclerosis

Published online by Cambridge University Press:  02 December 2014

Yunyan Zhang ,
Luanne M Metz ,
V Wee Yong ,
Robert B Bell ,
Michael Yeung ,
David G Patry  and
J Ross Mitchell
Yunyan Zhang
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
Luanne M Metz
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
V Wee Yong
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada Department of Oncology, University of Calgary, Calgary, AB, Canada
Robert B Bell
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
Michael Yeung
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
David G Patry
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
J Ross Mitchell
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada Department of Radiology, University of Calgary, Calgary, AB, Canada
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Abstract

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Background:

Current multiple sclerosis (MS) treatment is only partially effective and not all patients respond well. The goal in this study was to evaluate minocycline for its safety, tolerability, and MRI impact as a potential therapy over 36 months after a three month run-in in ten relapsing-remitting (RR) MS patients.

Methods:

Clinical assessments were at three month intervals until six months, then at six month intervals. Three Tesla MRI was performed monthly during the run-in and first six months of treatment, then at 12, 24, and 36 months.

Results:

Treatment was safe and well tolerated. Annualized relapse rate was 1.2 during the run-in and 0.25 during treatment. The proportion of active scans was lower during the first six months of treatment (5.6%, p<0.001) and during the extension (8.7%, p= 0.002) than during the run-in (47.5%). Consistent with these outcomes, mean T2 lesion volume remained stable over three years and percent brain volume change was reduced during year three (-0.37%) of minocycline treatment.

Conclusions:

This trial is limited by small sample and no control group but suggests that minocycline is safe and potentially beneficial in RRMS. This supports further investigation of its efficacy.

résumé:

<span class='bold'>RÉSUMÉ:</span> <span class='bold'> <span class='italic'>Contexte:</span></span>

Le traitement actuel de la sclerose en plaques n’est que partiellement efficace et certains patients n’y repondent pas bien. Le but de cette etude etait d’evaluer la securite, la tolerance et l’impact sur l’IRM de l’administration de minocycline pendant 36 mois, apres une phase de preinclusion de 3 mois, chez dix patients atteints de la forme cyclique remittente de la sclerose en plaques (SEP).

<span class='bold'> <span class='italic'>Méthodes:</span></span>

On a procede a une evaluation clinique aux 3 mois pendant 6 mois, puis aux 6 mois par la suite. Les patients ont subi 3 IRM Tesla par mois au cours de la phase de preinclusion et des 6 premiers mois de traitement, puis aux 12e, 24e et 36e mois.

<span class='bold'> <span class='italic'>Résultats:</span></span>

Le traitement etait sur et bien tolere. Le taux de rechute annualise a ete de 1,2 pendant la phase de preinclusion et de 0,25 pendant le traitement. La proportion de scans montrant une activite etait plus faible pendant les 6 premiers mois de traitement (5,6%, p < 0,01) et pendant l’extension (8,7%, p = 0,002) que pendant la phase de preinclusion (47,5%). Le volume moyen des lesions en T2 est demeure stable pendant 3 ans et le pourcentage de changement du volume cerebral a diminue pendant la troisieme annee de traitement par la minocycline (– 0,37%).

<span class='bold'> <span class='italic'>Conclusions:</span></span>

Cette etude ne comportait qu’un petit nombre de patients et aucun groupe temoin. Cependant, les resultats indiquent que la minocycline est sure et potentiellement benefique dans la SEP cyclique remittente et merite qu’on etudie davantage son efficacite.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 35 , Issue 2 , May 2008 , pp. 185 - 191
Copyright
Copyright © The Canadian Journal of Neurological 2008

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