Minocycline FAQ
October 2007
What is minocycline?
Minocycline is used to treat bacterial infections including acne; pneumonia
and other respiratory tract infections; and infections of skin, genital,
and urinary systems.
Minocycline is in a class of medications called tetracycline antibiotics.
It works by preventing the growth and spread of bacteria. It comes in
pill format.
Recent studies have demonstrated its anti-inflammatory properties, a
key factor for MS researchers to look closely at the drug.
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Are there any side effects?
Every drug has potential side effects. The side effects that
are most common in people treated with minocycline include:
- diarrhea
- dizziness or lightheadedness
- grey discoloration of the skin or tissue in the mouth including
the teeth
- sun sensitivity
- Secondary infection due to fungi which can cause itching of the
rectum or vagina
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How does it work?
Minocycline is believed to work by inhibiting the activities of an enzyme
that is a key player in initiating inflammation in the brain in MS. It
has been used in acne treatment for its anti-bacterial effects but studies
have shown it also has anti-inflammatory properties, a key factor in slowing
down MS.
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Is minocycline a cure for MS?
No, but if the research hypotheses are confirmed, minocycline
may prove to be an effective early treatment that delays
the full onset of multiple sclerosis.
Early studies have shown an 84% reduction in MS lesion activity on brain
MRI, meaning this treatment has the potential to slow the disease down
significantly.
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Will minocycline be a replacement for current disease modifying therapies?
Researchers note that minocycline wouldn’t necessarily replace current
therapies, but would likely become another treatment option. Individual
response is expected to vary. It may delay the timeframe in which other
treatments would be required and it may prove to be useful in combination
with other approved therapies.
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How much does it cost?
In generic form minocycline can cost as little as $1 per dose. Based
on two doses a day, this works out to approximately $800/year. Other MS
disease modifying therapies can cost between $18,000 and $40,000/year.
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Can I get it now?
Minocycline is generally available as a prescription medication
for acne and other bacterial infections but until it is proven
to be beneficial it is not recommended for treatment of MS.
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Tell
me more about the study: where are the goals and how is it
designed?
Enrolment is expected to begin in early 2008. It is double-blind,
placebo controlled and involves 200 people taking oral
minocycline, 100 mg, twice daily. Up to 280 people will be screened for
inclusion with the expectation that 30% will not be eligible.
Target population for inclusion: female and male, 18-50 years old, first
MS symptoms within the previous 90 days and a brain MRI with at least
two lesions present. This means that people who currently have MS or suspected
MS will not be eligible for this clinical trial.
The goal of the study is to delay the conversion time from Clinically
Isolate Syndrome (CIS, or the first attack of MS symptoms) to clinically
definite MS. Clinically definite MS is based on a second relapse or very
specific changes during follow-up on MRI.
The goal of the study is to achieve a reduction in the proportion of
people who convert to clinically definite MS by the end of 6 months compared
to placebo. The study will follow participants to the end of 24 months.
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How can I get involved?
The best way to support MS research initiatives like this is
by donating to the MS Society of Canada. Please visit www.mssociety.ca to donate.
For this particular study, enrollment does not begin until 2008. At this
time, study sites will enroll people within 90 days of their first attack
of MS like symptoms. People who currently have MS or suspected MS are
not eligible.
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What about the use of minocycline in other diseases like stroke and
ALS?
Minocycline has been tested to treat other diseases like stroke and ALS
with varied results. In MS, researchers are looking at minocycline to
influence a target that is very specific to MS. Preliminary research has
demonstrated that minocycline has great potential to slow down the progression
of MS. This work has led to the development of a new $4 million phase
III clinical trial involving 200 people and funded by the MS Society of
Canada’s related MS Scientific Research Foundation.
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What institutions and researchers are involved?
The clinical steering committee is comprised of:
Dr. Luanne Metz (principal investigator), University of Calgary,
Hotchkiss Brain Institute
Dr. Anthony Traboulsee, University of British Columbia
Dr. David Li, University of British Columbia
Dr. Pierre Duquette, University of Montreal
Dr. Paul O’Connor, University of Toronto
Dr. Jack Antel, McGill University, Montreal Neurological Institute
Dr. Michael Hill, University of Calgary, Hotchkiss Brain Institute
Dr. Sam Wiebe, University of Calgary, Hotchkiss Brain Institute
Dr. Michael Eliasziw, University of Calgary, Hotchkiss Brain
Institute
The biomedical research team is comprised of:
Dr. V Wee Yong (team leader), University of Calgary, Hotchkiss
Brain Institute
Dr. Alexandre Prat, University of Montreal
Dr. Amit Bar-Or, McGill University, Montreal Neurological Institute
The independent safety monitoring committee is comprised of:
Dr. T Jock Murray (chair), Dalhousie University
Dr. Ruth Ann Marrie, University of Manitoba
Dr. Brenda Banwell, University of Toronto
In addition, the following institutions are involved:
University of Calgary, Hotchkiss Brain Institute, Calgary
Dr. Michael Yeung (Site Lead Investigator)
University of British Columbia, Vancouver
Dr. Anthony Traboulsee (Site Lead Investigator)
Fraser Health MS Clinic, Burnaby Hospital
Dr. Galina Vorobeychik (Site Lead Investigator)
University of Alberta, Edmonton
Dr. Gregg Blevins (Site Lead Investigator)
David Thompson Health Region, Red Deer
Dr. Jacqueline Bakker (Site Lead Investigator)
University of Saskatchewan, Saskatoon
Dr. Carol Boyle (Site Lead Investigator)
University of Western Ontario, London
Dr. Marcelo Kremenchutzky (Site Lead Investigator)
University of Toronto
Dr. Paul O’Connor (Site Lead Investigator)
Queen’s University, Kingston
Dr. Don Brunet (Site Lead Investigator)
University of Ottawa
Dr. Mark Freedman (Site Lead Investigator)
University of Montreal
Dr. Pierre Duquette (Site Lead Investigator)
Université Laval, Quebec City
Dr. Manon Thibault (Site Lead Investigator)
Neuro Rive-Sud, Université de Sherbrooke
Dr. Francois Grand’Maison (Site Lead Investigator)
Dalhousie University, Halifax
Dr. Virender Bhan (Site Lead Investigator)
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