An open-label evaluator-blinded clinical study of minocycline neuroprotection in ischemic stroke: Gender-dependent effect

Minocycline as an antibiotic has been found to have
neuroprotective effect on neurodegenerative diseases. This study was
aimed at determining the efficacy of minocycline adjunct to aspirin in
improving neurological outcomes of ischemic stroke during 3-month
follow-up. Methods and materials – In an open-label evaluator-blinded
trial, 60 patients with ischemic stroke were allocated into two groups
to receive either 200 mg of oral minocycline daily for 5 days during
6–24 h following onset of signs and symptoms, or not receiving any,
as control; all patients also received 100 mg of aspirin daily. Clinical
assessment at baseline and on days 30, 60, and 90 was performed
using National Institutes of Health Stroke Scale (NIHSS) score.
Results – Fifty-three patients (88.3%) completed the study. Females in
the treatment and control groups were 53.8% and 51.9%, respectively
(P = 0.884). Among all patients, NIHSS score was significantly lower
in the minocycline-treated compared with control on day 90
(minocycline median 4, interquartile range 4–7, control median 7,
interquartile range 5–8, P = 0.031). Among males, NIHSS was lower
in minocycline-treated compared with controls on days 30, 60, and 90
(P < 0.05); however, females showed no significant differences at the
same times compared with controls. No adverse outcomes including
myocardial infarction, recurrent stroke, and mortality were observed
in the both groups. Conclusion – Patients with ischemic stroke who
received oral minocycline daily for 5 days had significantly better
neurological outcomes on day 90 than controls. However, females
showed no significant clinical improvement compared to males