Trial of Minocycline in a Clinically Isolated Syndrome of Multiple Sclerosis

The risk of conversion from a first demyelinating event to MS was lower with minocycline than with placebo over 6 months but not over 24 months. Changes of demyelination on MRI favored minocycline over placebo. Adverse events were more frequent with minocycline. After a first focal clinical demyelinating event (also called a clinically isolated syndrome), the risk of conversion to multiple sclerosis is high. Minocycline is a tetracycline antibiotic agent that has immune-modulating properties; preliminary data have shown activity of minocycline in patients with multiple sclerosis. 1 – 4 Minocycline has a good safety profile, 5 although rash, headache, dizziness, and photosensitivity are common side effects. Pseudotumor cerebri and hypersensitivity syndromes are rare but serious complications, and hyperpigmentation may occur with long-term use. Antibiotic resistance is infrequently associated with minocycline therapy. 6 In one small clinical trial involving patients with relapsing–remitting multiple sclerosis, minocycline therapy reduced . . .