Τίτλος:
Minocycline and matrix metalloproteinase inhibition in acute intracerebral hemorrhage: a pilot study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background and purpose: Intracerebral hemorrhage (ICH) is a devastating cerebrovascular disorder with high morbidity and mortality. Minocycline is a matrix metalloproteinase-9 (MMP-9) inhibitor that may attenuate secondary mechanisms of injury in ICH. The feasibility and safety of minocycline in ICH patients were evaluated in a pilot, double-blinded, placebo-controlled randomized clinical trial. Methods: Patients with acute onset (<12 h from symptom onset) ICH and small initial hematoma volume (<30 ml) were randomized to high-dose (10 mg/kg) intravenous minocycline or placebo. The outcome events included adverse events, change in serial National Institutes of Health Stroke Scale score assessments, hematoma volume and MMP-9 measurements, 3-month functional outcome (modified Rankin score) and mortality. Results: A total of 20 patients were randomized to minocycline (n = 10) or placebo (n = 10). The two groups did not differ in terms of baseline characteristics. No serious adverse events or complications were noted with minocycline infusion. The two groups did not differ in any of the clinical and radiological outcomes. Day 5 serum MMP-9 levels tended to be lower in the minocycline group (372 ± 216 ng/ml vs. 472 ± 235 ng/ml; P = 0.052). Multiple linear regression analysis showed that minocycline was associated with a 217.65 (95% confidence interval −425.21 to −10.10, P = 0.041) decrease in MMP-9 levels between days 1 and 5. Conclusions: High-dose intravenous minocycline can be safely administered to patients with ICH. Larger randomized clinical trials evaluating the efficacy of minocycline and MMP-9 inhibition in ICH patients are required. © 2017 EAN
Συγγραφείς:
Chang, J.J.
Kim-Tenser, M.
Emanuel, B.A.
Jones, G.M.
Chapple, K.
Alikhani, A.
Sanossian, N.
Mack, W.J.
Tsivgoulis, G.
Alexandrov, A.V.
Pourmotabbed, T.
Περιοδικό:
European Journal of Paediatric Neurology
Εκδότης:
Wiley-Blackwell Publishing Ltd
Λέξεις-κλειδιά:
gelatinase B; minocycline; placebo; matrix metalloproteinase inhibitor; minocycline, acute disease; adult; Article; Barthel index; blood volume; brain edema; brain hematoma; brain hemorrhage; brain radiography; clinical article; clinical outcome; computer assisted tomography; controlled study; decompressive craniectomy; disease severity; double blind procedure; drug megadose; drug safety; drug tolerability; enzyme inhibition; feasibility study; female; follow up; Glasgow coma scale; human; male; middle aged; mortality; National Institutes of Health Stroke Scale; pilot study; priority journal; protein blood level; randomized controlled trial; Rankin scale; aged; brain hemorrhage; pathology; treatment outcome, Adult; Aged; Cerebral Hemorrhage; Double-Blind Method; Female; Humans; Male; Matrix Metalloproteinase Inhibitors; Middle Aged; Minocycline; Pilot Projects; Treatment Outcome
