title: Reducing haemorrhagic transformation after thrombolysis for stroke: a strategy utilising minocycline.
abstract: Haemorrhagic transformation (HT) of recently ischaemic brain is a feared complication of thrombolytic therapy that may be caused or compounded by ischaemia-induced activation of matrix metalloproteinases (MMPs). The tetracycline antibiotic minocycline inhibits matrix MMPs and reduces macroscopic HT in rodents with stroke treated with tissue plasminogen activator (tPA). The West Australian Intravenous Minocycline and TPA Stroke Study (WAIMATSS) aims to determine the safety and efficacy of adding minocycline to tPA in acute ischaemic stroke. The WAIMATSS is a multicentre, prospective, and randomised pilot study of intravenous minocycline, 200 mg 12 hourly for 5 doses, compared with standard care, in patients with ischaemic stroke treated with intravenous tPA. The primary endpoint is HT diagnosed by brain CT and MRI. Secondary endpoints include clinical outcome measures. Some illustrative cases from the early recruitment phase of this study will be presented, and future perspectives will be discussed.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia and School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA 6009, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Blacker
authors.forename: David
authors.initials: D
authors.lastname: Prentice
authors.forename: Anthony
authors.initials: A
authors.lastname: Alvaro
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Bates
authors.forename: Michael
authors.initials: M
authors.lastname: Bynevelt
authors.forename: Andrew
authors.initials: A
authors.lastname: Kelly
authors.forename: Lay Kun
authors.initials: LK
authors.lastname: Kho
authors.forename: Edith
authors.initials: E
authors.lastname: Kohler
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.forename: Andrew
authors.initials: A
authors.lastname: Thompson
authors.forename: Taryn
authors.initials: T
authors.lastname: Major