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Use of doxycycline to decrease the growth rate of abdominal aortic aneurysms: a randomized, double-blind,

M Mosorin¹, J Juvonen, F Biancari

¹Department of Surgery, University of Oulu, Finland.

Journal of Vascular Surgery

|October 23, 2001

Summary

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Doxycycline may slow the growth of small abdominal aortic aneurysms (AAA). This pilot study found lower expansion rates in patients treated with doxycycline compared to placebo, suggesting a potential medical treatment for AAA.

Area of Science:

Cardiovascular Medicine
Infectious Diseases

Background:

Small abdominal aortic aneurysms (AAA) pose a significant health risk.
Doxycycline's potential to inhibit matrix metalloproteinases and eradicate Chlamydia pneumoniae infection suggests it may reduce AAA growth.

Purpose of the Study:

To investigate the efficacy of doxycycline in reducing the expansion rate of small abdominal aortic aneurysms (AAA).

Main Methods:

Prospective, double-blind, randomized, placebo-controlled trial involving 32 patients with small AAAs.
Patients received either 150 mg doxycycline daily or placebo for 3 months, with 18 months of ultrasound surveillance.
Outcome measures included aneurysm expansion rates, AAA rupture/repair events, Chlamydia pneumoniae antibody titers, and C-reactive protein levels.

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Main Results:

Significantly lower aneurysm expansion rates were observed in the doxycycline group compared to the placebo group at 6-12 and 12-18 month intervals.
Fewer patients in the doxycycline group (7%) experienced >= 5 mm expansion versus the placebo group (41%) over 18 months.
Doxycycline treatment led to significantly lower C-reactive protein levels at 6 months, but did not clearly affect Chlamydia pneumoniae antibody titers.

Conclusions:

This small pilot study suggests doxycycline may favorably impact outcomes in patients with small abdominal aortic aneurysms.
Further multicenter studies are warranted to confirm these findings and establish a role for medical treatment in small AAAs due to the study's limitations.
The clinical, social, and economic relevance of AAA necessitates further investigation into effective medical interventions.