This Article Full Text (PDF) All Versions of this Article: 1352458509106779v1 15/10/1183    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Metz, L. Articles by Yong, V. PubMed PubMed Citation Articles by Metz, L. Articles by Yong, V. Social Bookmarking                         What's this?

Glatiramer acetate in combination with minocycline in patients with relapsing—remitting multiple sclerosis: results of a Canadian, multicenter, double-blind, placebo-controlled trial

Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada, lmetz{at}ucalgary.ca

D. Li

UBC MS/MRI Research Group, University of British Columbia, Vancouver, British Columbia, Canada

A. Traboulsee

UBC MS/MRI Research Group, University of British Columbia, Vancouver, British Columbia, Canada

ML Myles

The Northern Alberta Clinical Trials and Research Centre, University of Alberta, Edmonton, Alberta, Canada

P. Duquette

Hôpital Notre-Dame, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada

J. Godin

Teva Neuroscience, Montreal, Quebec, Canada

M. Constantin

Teva Neuroscience, Montreal, Quebec, Canada

VW Yong

Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada

Minocycline is proposed as an add-on therapy to improve the efficacy of glatiramer acetate in relapsing—remitting multiple sclerosis. The effect of minocycline plus glatiramer acetate was evaluated in this double-blind, placebo-controlled study by determining the total number of T1 gadolinium-enhanced lesions at months 8 and 9 in patients who were starting glatiramer acetate and had at least one T1 gadolinium-enhanced lesion on screening magnetic resonance imaging. Forty-four participants were randomized to either minocycline 100 mg twice daily or matching placebo for 9 months as add-on therapy. They were assessed at screening and months 1, 3, 6, 8 and 9. Forty participants completed the study. Compared with glatiramer acetate/placebo, glatiramer acetate/minocycline reduced the total number of T1 gadolinium-enhanced lesions by 63% (mean 1.47 versus 2.95; p = 0.08), the total number of new and enlarging T2 lesions by 65% (mean 1.84 versus 5.14; p = 0.06), and the total T2 disease burden (p = 0.10). A higher number of gadolinium-enhanced lesions were present in the glatiramer acetate/minocycline group at baseline; this was incorporated into the analysis of the primary endpoint but makes interpretation of the data more challenging. The risk of relapse tended to be lower in the combination group (0.19 versus 0.41; p = NS). Treatment was safe and well tolerated. We conclude that efficacy endpoints showed a consistent trend favoring combination treatment. As minocycline is a relatively safe oral therapy, further study of this combination is warranted in relapsing—remitting multiple sclerosis.

Key Words: multiple sclerosis • glatiramer acetate • minocycline • tetracycline • clinical trial • magnetic resonance imaging

This version was published on October 1, 2009

Multiple Sclerosis, Vol. 15, No. 10, 1183-1194 (2009)
DOI: 10.1177/1352458509106779


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?