Feasibility of minocycline and doxycycline use as potential vasculostatic therapy for brain vascular malformations: pilot study of adverse events and tolerance.

Abstract

BACKGROUND:

Tetracyclines may be useful in preventing pathological vascular remodeling, thus decreasing the risk of spontaneous hemorrhage from brain vascular malformations.

METHODS:

Arteriovenous malformation (AVM) and intracranial aneurysm patients undergoing noninvasive management were treated with minocycline or doxycycline (200 mg/day) up to 2 years in a prospective open-label safety pilot trial. The primary outcome was to compare dose-limiting intolerance, defined as treatment-related dose reduction or withdrawal between the agents.

RESULTS:

Twenty-six patients with AVMs (n = 12) or aneurysms (n = 14) were recruited. Adverse event rates were similar to other reported trials of these agents; 4 of 13 (31%) minocycline and 3 of 13 (23%) doxycycline patients had dose-limiting intolerance (hazard ratio = 3.1, 95% CI = 0.52-18.11, log rank p = 0.70).

CONCLUSIONS:

It is feasible to propose a long-term trial to assess the potential benefit of tetracycline therapy to decrease hemorrhagic risk in brain vascular malformations.

• Authors: Tim Frenzel, Chanhung Z Lee, Helen Kim, Nancy J Quinnine, Tomoki Hashimoto, Michael T Lawton, B Joseph Guglielmo, Charles E McCulloch, William L Young
• Journal: Cerebrovascular diseases (Basel, Switzerland) (Cerebrovasc Dis) Vol. 25 Issue 1-2 Pg. 157-63 ( 2008) ISSN: 1421-9786 [Electronic] Switzerland
• PMID: 18212521 (Publication Type: Clinical Trial, Clinical Trial, Phase I, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: (c) 2008 S. Karger AG, Basel.

Chemical References

• Anti-Bacterial Agents
• Minocycline
• Doxycycline

Topics

• Adolescent
• Adult
• Aged
• Anti-Bacterial Agents (administration & dosage, adverse effects)
• Dose-Response Relationship, Drug
• Doxycycline (administration & dosage, adverse effects)
• Feasibility Studies
• Follow-Up Studies
• Humans
• Intracranial Aneurysm (drug therapy)
• Intracranial Arteriovenous Malformations (drug therapy)
• Middle Aged
• Minocycline (administration & dosage, adverse effects)
• Pilot Projects
• Prospective Studies
• Treatment Outcome