Feasibility of minocycline and doxycycline use as potential vasculostatic therapy for brain vascular malformations: Pilot study of adverse events and tolerance
Feasibility of minocycline and doxycycline use as potential vasculostatic therapy for brain vascular malformations: Pilot study of adverse events and tolerance
复制标题
DOI：
10.1159/000113733
复制
发表时间：
2008-01-01
影响因子：
2.9
通讯作者：
Young, William L.
中科院分区：
文献类型：
--
作者：
Frenzel, Tim;Lee, Chanhung Z.;Young, William L.
背景：四环素可能有助于预防病理性血管重塑，从而降低脑血管畸形引起自发性出血的风险。方法：在一项前瞻性开放标签安全试点试验中，接受无创治疗的动静脉畸形 (AVM) 和颅内动脉瘤患者接受米诺环素或多西环素（200 毫克/天）治疗长达 2 年。主要结果是比较剂量限制性不耐受，定义为药物之间与治疗相关的剂量减少或停药。结果：招募了 26 名患有 AVM（n = 12）或动脉瘤（n = 14）的患者。不良事件发生率与这些药物的其他报道试验相似； 13 名米诺环素患者中的 4 名 (31%) 和 13 名多西环素患者中的 3 名 (23%) 存在剂量限制性不耐受（风险比 = 3.1，95% CI = 0.52-18.11，对数秩 p = 0.70）。结论：提出一项长期试验来评估四环素治疗降低脑血管畸形出血风险的潜在益处是可行的。版权所有 (C) 2008 S. Karger AG，巴塞尔。
Background: Tetracyclines may be useful in preventing pathological vascular remodeling, thus decreasing the risk of spontaneous hemorrhage from brain vascular malformations. Methods: Arteriovenous malformation (AVM) and intracranial aneurysm patients undergoing noninvasive management were treated with minocycline or doxycycline (200 mg/day) up to 2 years in a prospective open-label safety pilot trial. The primary outcome was to compare dose-limiting intolerance, defined as treatment-related dose reduction or withdrawal between the agents. Results: Twenty-six patients with AVMs (n = 12) or aneurysms (n = 14) were recruited. Adverse event rates were similar to other reported trials of these agents; 4 of 13 (31%) minocycline and 3 of 13 (23%) doxycycline patients had dose-limiting intolerance (hazard ratio = 3.1, 95% CI = 0.52-18.11, log rank p = 0.70). Conclusions: It is feasible to propose a long-term trial to assess the potential benefit of tetracycline therapy to decrease hemorrhagic risk in brain vascular malformations. Copyright (C) 2008 S. Karger AG, Basel.