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Reducing haemorrhagic transformation after thrombolysis for stroke: a strategy utilising minocycline

David J Blacker1, David Prentice, Anthony Alvaro

  • 1Department 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.

Stroke Research and Treatment
|May 22, 2013
PubMed

Insights

Minocycline may reduce haemorrhagic transformation (HT) after ischemic stroke treatment with tissue plasminogen activator (tPA). This pilot study assesses the safety and efficacy of adding minocycline to tPA for acute stroke patients.

Area of Science:

  • Neurology
  • Pharmacology
  • Stroke Research

Background:

  • Haemorrhagic transformation (HT) is a serious complication of acute ischemic stroke treated with thrombolytics like tissue plasminogen activator (tPA).
  • Ischemia-induced matrix metalloproteinases (MMPs) activation is implicated in causing or worsening HT.
  • Minocycline, a tetracycline antibiotic, is known to inhibit MMPs and has shown potential in reducing HT in animal models.

Purpose of the Study:

  • To evaluate the safety and efficacy of combining intravenous minocycline with intravenous tPA for acute ischemic stroke.
  • To determine if minocycline reduces the incidence or severity of haemorrhagic transformation in stroke patients receiving tPA.

Main Methods:

  • The West Australian Intravenous Minocycline and TPA Stroke Study (WAIMATSS) is a multicenter, prospective, randomized pilot trial.
  • Patients with acute ischemic stroke treated with tPA received either intravenous minocycline (200 mg every 12 hours for 5 doses) or standard care.
  • Primary endpoint: diagnosis of HT via brain CT and MRI. Secondary endpoints: clinical outcome measures.

Main Results:

  • Illustrative cases from the early recruitment phase will be presented.
  • Data on the primary endpoint (HT) and secondary clinical outcomes are being collected and analyzed.

Conclusions:

  • The study aims to provide preliminary data on the safety and efficacy of minocycline as an adjunct therapy in acute ischemic stroke.
  • Findings will inform future larger trials investigating minocycline for stroke treatment and HT prevention.

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