- Route of Administration: Oral
- Type: Tetracycline antibiotic
- Emerging treatment for: Clinically isolated syndrome, RRMS
- Status: In Phase III of clinical trials
How it Works
In addition to its antibacterial activity, minocycline boasts both anti-inflammatory and neuroprotective properties that make it a promising therapeutic candidate for MS. Minocycline has been shown to suppress the activity of various pro-inflammatory cells and molecules, and prevent the infiltration of immune cells into the central nervous system.
Minocycline is hypothesized to promote neuroprotection through three mechanisms: inhibiting the death of myelin-producing cells; reducing cellular damage to nerve fibres through its antioxidant properties, and; protecting against excitotoxicity, the process by which nerve cells are damaged or destroyed by excessive stimulation by certain brain chemicals
Research and Results
A number of animal studies and human pilot trials have conferred beneficial properties of minocycline in MS. Further, a phase II, multi-centre, double-blind, placebo-controlled clinical trial led by Dr. Metz and team compared the efficacy of minocycline administered in combination with glatiramer acetate to glatiramer acetate and placebo in 44 participants with relapsing-remitting MS. Treatment with minocycline and glatiramer acetate reduced the number lesions on MRI, although it did not reach statistical significance.
In 2007 Dr. Metz received funding from the Multiple Sclerosis Scientific Research Foundation to launch a phase III clinical trial observing the safety and efficacy of minocycline in patients who experienced initial symptoms suggestive of MS. The trial enrolled 142 participants who were randomly assigned to receive either minocycline at a dose of 100mg orally twice-a-day, or placebo. Unpublished results will be presented at the 31st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). The MS Society and the medical community are awaiting the published results to understand the details which are needed to guide recommendations about the use of minocycline.
Adverse Effects Reported
Minocycline has an established safety track record based on several decades as an indication for acne vulgaris. The most common short term side effects in people treated with minocycline observed in MS trials include: diarrhea; dizziness or light-headedness; grey discoloration of the skin or tissue in the mouth including the teeth; sun sensitivity and secondary infection due to fungi which can cause itching of the rectum or vagina.
- Metz, LM, Li D, Traboulsee A, Myles ML, Duquette P, Godin J, Constantin M, Yong VW, GA/minocycline study investigators. Glatiramer acetate in combination with minocycline in patients with relapsing--remitting multiple sclerosis: results of a Canadian, multicenter, double-blind, placebo-controlled trial. Mult Scler. 2009; 15(10):1183-94.
- Zabad RK, Metz LM, Todoruk TR, Zhang Y, Mitchell JR, Yeung M, Patry DG, Bell RB and Yong VW. The clinical response to minocycline in multiple sclerosis is accompanied by beneficial immune changes: a pilot study. Mult Scler. 2007; 13(4):517-26.
- Zhang Y, Metz LM, Yong VW, Bell RB, Yeung M, Patry DG and Mitchell JR. Pilot study of minocycline in relapsing-remitting multiple sclerosis. Can J Neurol Sci. 2008; 35(2):185-91.