title: Efficacy of minocycline in acute ischemic stroke: a single-blinded, placebo-controlled trial.
abstract: BACKGROUND
  Minocycline is a semisynthetic derivative of the tetracycline group of antibiotics, which have neuroprotective effects. In animal stroke models, minocycline had shown promising evidence to improve clinical and functional outcomes.
  
  
  OBJECTIVE
  To analyze the effect of oral minocycline in acute ischemic stroke patients.
  
  
  METHODS
  This was a randomized single-blinded open-label study. The study group received oral minocycline 200 mg/day for 5 days and the control group received oral vitamin B capsules. Baseline assessment included the following: National Institute of Health Stroke Scale (NIHSS) score, modified Barthel Index (mBI), modified Rankin Scale (mRS) score, Magnetic Resonance Imaging (MRI) of brain including Diffusion Weighted Imaging (DWI), chest X-ray, and routine laboratory investigations. The clinical scales were repeated at days 1, 7, and 30. The end point was outcomes at 3 months (90 days). Statistical analysis was done with SPSS 11.5 (P<0.05). Paired t-test and multiple-measures Analysis Of Variance (ANOVA) were used.
  
  
  RESULTS
  Fifty patients with acute ischemic stroke were included in the study. Of these, 23 patients received minocycline and 27 patients received placebo i.e., vitamin B capsules. NIHSS score in patients receiving minocycline had shown statistically significant improvement at day 30 and 90 as compared with the controls. Similarly, mRS scores and BI showed significant improvement in patients receiving minocycline at three months as compared to the control group. No mortality, myocardial infarctions, recurrent strokes, and hemorrhagic transformations were noted in both groups.
  
  
  CONCLUSIONS
  Patients with acute ischemic stroke had significantly better outcome with minocycline treatment as compared with those administered placebo. The above findings suggest that minocycline can be helpful in reducing the clinical deficits after acute ischemic stroke.
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India. vasanthapadma123@gmail.com
authors.forename: M V
authors.initials: MV
authors.lastname: Padma Srivastava
authors.forename: Ashu
authors.initials: A
authors.lastname: Bhasin
authors.forename: R
authors.initials: R
authors.lastname: Bhatia
authors.forename: Ajay
authors.initials: A
authors.lastname: Garg
authors.forename: Shailesh
authors.initials: S
authors.lastname: Gaikwad
authors.forename: Kameshwar
authors.initials: K
authors.lastname: Prasad
authors.forename: Mamta Bhushan
authors.initials: MB
authors.lastname: Singh
authors.forename: Manjiri
authors.initials: M
authors.lastname: Tripathi
mesh_terms: D000203:Activities of Daily Living; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use*; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000188:drug therapy*
chemical_list: D018696:Neuroprotective Agents; D008911:Minocycline