Drug May Widen the Stroke Treatment Window
Antibiotic shows promise against strokes caused by blood clots

(HealthDay News) -- A drug used to treat acne and urinary tract infections also appears to be a powerful weapon against strokes caused by blood clots.

And that discovery could widen the window of treatment for a stroke from a few hours to as much as 24 hours.

The antibiotic minocycline is a tetracycline derivative that's long been used to combat bacterial infections. In recent years, researchers have found that the drug is also effective in animal models of a number of neurological disorders, including Parkinson's, Huntington's and Lou Gehrig's diseases.

And in a study published in the journal Neurology , a team of Israeli researchers concluded that minocycline may benefit people with acute ischemic stroke.

The study included 152 people who'd just had a stroke and were randomly given either 200 milligrams of minocycline or a placebo once a day for five days. Treatment started between six and 24 hours after the start of their stroke.

At one week, one month and three months after their stroke, people in the minocycline group showed greater improvement than those in the placebo group in assessments of neurological damage and the ability to perform such daily tasks as grooming, dressing and using the bathroom.

Dr. Eric Smith, associate director of Acute Stroke Services at Massachusetts General Hospital in Boston , noted that the results showed a rather marked difference between the two groups. "Clinically, it is the difference between someone who looks almost normal compared to someone with more mild-to-moderate impairment due to stroke," he told HealthDay .

In an ischemic stroke, a clot cuts off blood flow to parts of the brain. Smith said it appears that minocycline acts as a neuroprotectant -- that is, a compound that reduces the amount of brain damage caused by the lack of oxygen and glucose that occurs when the blood flow is cut off.

Though it's not clear how minocycline acts as a neuroprotectant, there are several possible mechanisms. The Israeli team suggested the effect "is at least partially dependent" on minocycline's ability to limit inflammation and cell suicide (apoptosis).

If the results of the Israeli study are confirmed in larger, more stringent clinical trials, "it will be probably one of the most used and effective treatments of ischemic stroke that we have," said Dr. Argye Hillis, a neurology professor at Johns Hopkins School of Medicine in Baltimore .

She described the results as "potentially very exciting" because of the extent of the drug's effect and because the researchers found minocycline could be administered as much as a day after someone had had a stroke.

"They included patients who were eight to 24 hours after onset of stroke, on average 12 hours," Hillis told HealthDay . "That's exciting, because that's about when most patients come to the hospital."

Currently, most stroke treatments are effective only if given within a few hours of stroke onset, a treatment window that's too short to be effective for most people, she said.

On the Web

To learn more about stroke prevention and treatment, visit the U.S. Food and Drug Administration online.

SOURCES: HealthDay News ; Yair Lampl, M.D., Department of Neurology, Edith Wolfson Medical Center, Holon, Israel; Eric Smith, M.D., assistant professor of neurology and associate director, Acute Stroke Services, Massachusetts General Hospital and Harvard Medical School, Boston; Argye Hillis, M.D., professor of neurology, Johns Hopkins University School of Medicine, Baltimore; Oct. 2, 2007, Neurology
Author: Robert Preidt
Publication date: Sept. 30, 2008
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