Efficacy of Minocycline in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Rodent and Clinical Studies

This study aimed to assess the efficacy of minocycline for the treatment of acute ischemic stroke. While there have been meta-analysis that surveyed the efficacy of minocycline in the treatment of acute stroke, they have some methodological limitations. We performed a new systematic review which was...

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Published inFrontiers in neurology Vol. 9; p. 1103
Main Authors Sheng, Zhaofu, Liu, Yang, Li, Hongmin, Zheng, Wei, Xia, Bin, Zhang, Xin, Yong, V Wee, Xue, Mengzhou
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 20.12.2018
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Abstract This study aimed to assess the efficacy of minocycline for the treatment of acute ischemic stroke. While there have been meta-analysis that surveyed the efficacy of minocycline in the treatment of acute stroke, they have some methodological limitations. We performed a new systematic review which was distinct from previous one by adding new outcomes and including new studies. Document retrieval was executed through PubMed, Cochrane Central Register of Controlled Trials, the Stroke Center, NIH's Clinical Trials, Current Controlled Trials, and the WHO International Clinical Trials Registry Platform Search Portal before Jan 2018. The data meeting the inclusion criteria were extracted. Before meta-analysis, publication bias and heterogeneity of included studies were surveyed. Random and fixed-effects models were employed to calculate pooled estimates and 95% confidence intervals (CIs). Additionally, sensitivity and subgroup analyses were implemented. For clinical studies, 4 trials with 201 patients in the minocycline group, and 195 patients in the control group met the inclusion criteria; 3 were randomized trials. At the end of 90-day follow up or discharge day, results showed that the groups receiving minocycline were superior to the control group, with significant differences in the NIHSS scores (mean difference [MD], -2.75; 95% CI, -4.78, 0.27; = 0.03) and mRS scores (MD, -0.98; 95% CI, -1.27, -0.69; < 0.01), but not Barthel Index Score (MD, 9.04; 95% CI, -0.78, 18.07; = 0.07). For rodent experiments, 14 studies were included. Neurological severity scores (NSS) was significantly improved (MD, -1.38; 95% CI, -1.64, -1.31; < 0.01) and infarct volume was obviously reduced (Std mean difference [SMD], -2.38; 95% CI, -3.40, -1.36; < 0.01) in the minocycline group. Heterogeneity among the studies was proved to exist for infarct volume (Chi = 116.12, < 0.01; I = 0.89) but not for other variables. Based on the results in our study, minocycline appears as an effective therapeutic option for acute ischemic stroke.
AbstractList Objectives: This study aimed to assess the efficacy of minocycline for the treatment of acute ischemic stroke.Background: While there have been meta-analysis that surveyed the efficacy of minocycline in the treatment of acute stroke, they have some methodological limitations. We performed a new systematic review which was distinct from previous one by adding new outcomes and including new studies.Methods: Document retrieval was executed through PubMed, Cochrane Central Register of Controlled Trials, the Stroke Center, NIH's Clinical Trials, Current Controlled Trials, and the WHO International Clinical Trials Registry Platform Search Portal before Jan 2018. The data meeting the inclusion criteria were extracted. Before meta-analysis, publication bias and heterogeneity of included studies were surveyed. Random and fixed-effects models were employed to calculate pooled estimates and 95% confidence intervals (CIs). Additionally, sensitivity and subgroup analyses were implemented.Result: For clinical studies, 4 trials with 201 patients in the minocycline group, and 195 patients in the control group met the inclusion criteria; 3 were randomized trials. At the end of 90-day follow up or discharge day, results showed that the groups receiving minocycline were superior to the control group, with significant differences in the NIHSS scores (mean difference [MD], −2.75; 95% CI, −4.78, 0.27; p = 0.03) and mRS scores (MD, −0.98; 95% CI, −1.27, −0.69; p < 0.01), but not Barthel Index Score (MD, 9.04; 95% CI, −0.78, 18.07; p = 0.07). For rodent experiments, 14 studies were included. Neurological severity scores (NSS) was significantly improved (MD, −1.38; 95% CI, −1.64, −1.31; p < 0.01) and infarct volume was obviously reduced (Std mean difference [SMD], −2.38; 95% CI, −3.40, −1.36; p < 0.01) in the minocycline group. Heterogeneity among the studies was proved to exist for infarct volume (Chi2 = 116.12, p < 0.01; I2 = 0.89) but not for other variables.Conclusions: Based on the results in our study, minocycline appears as an effective therapeutic option for acute ischemic stroke.
This study aimed to assess the efficacy of minocycline for the treatment of acute ischemic stroke. While there have been meta-analysis that surveyed the efficacy of minocycline in the treatment of acute stroke, they have some methodological limitations. We performed a new systematic review which was distinct from previous one by adding new outcomes and including new studies. Document retrieval was executed through PubMed, Cochrane Central Register of Controlled Trials, the Stroke Center, NIH's Clinical Trials, Current Controlled Trials, and the WHO International Clinical Trials Registry Platform Search Portal before Jan 2018. The data meeting the inclusion criteria were extracted. Before meta-analysis, publication bias and heterogeneity of included studies were surveyed. Random and fixed-effects models were employed to calculate pooled estimates and 95% confidence intervals (CIs). Additionally, sensitivity and subgroup analyses were implemented. For clinical studies, 4 trials with 201 patients in the minocycline group, and 195 patients in the control group met the inclusion criteria; 3 were randomized trials. At the end of 90-day follow up or discharge day, results showed that the groups receiving minocycline were superior to the control group, with significant differences in the NIHSS scores (mean difference [MD], -2.75; 95% CI, -4.78, 0.27; = 0.03) and mRS scores (MD, -0.98; 95% CI, -1.27, -0.69; < 0.01), but not Barthel Index Score (MD, 9.04; 95% CI, -0.78, 18.07; = 0.07). For rodent experiments, 14 studies were included. Neurological severity scores (NSS) was significantly improved (MD, -1.38; 95% CI, -1.64, -1.31; < 0.01) and infarct volume was obviously reduced (Std mean difference [SMD], -2.38; 95% CI, -3.40, -1.36; < 0.01) in the minocycline group. Heterogeneity among the studies was proved to exist for infarct volume (Chi = 116.12, < 0.01; I = 0.89) but not for other variables. Based on the results in our study, minocycline appears as an effective therapeutic option for acute ischemic stroke.
Objectives: This study aimed to assess the efficacy of minocycline for the treatment of acute ischemic stroke. Background: While there have been meta-analysis that surveyed the efficacy of minocycline in the treatment of acute stroke, they have some methodological limitations. We performed a new systematic review which was distinct from previous one by adding new outcomes and including new studies. Methods: Document retrieval was executed through PubMed, Cochrane Central Register of Controlled Trials, the Stroke Center, NIH's Clinical Trials, Current Controlled Trials, and the WHO International Clinical Trials Registry Platform Search Portal before Jan 2018. The data meeting the inclusion criteria were extracted. Before meta-analysis, publication bias and heterogeneity of included studies were surveyed. Random and fixed-effects models were employed to calculate pooled estimates and 95% confidence intervals (CIs). Additionally, sensitivity and subgroup analyses were implemented. Result: For clinical studies, 4 trials with 201 patients in the minocycline group, and 195 patients in the control group met the inclusion criteria; 3 were randomized trials. At the end of 90-day follow up or discharge day, results showed that the groups receiving minocycline were superior to the control group, with significant differences in the NIHSS scores (mean difference [MD], −2.75; 95% CI, −4.78, 0.27; p = 0.03) and mRS scores (MD, −0.98; 95% CI, −1.27, −0.69; p < 0.01), but not Barthel Index Score (MD, 9.04; 95% CI, −0.78, 18.07; p = 0.07). For rodent experiments, 14 studies were included. Neurological severity scores (NSS) was significantly improved (MD, −1.38; 95% CI, −1.64, −1.31; p < 0.01) and infarct volume was obviously reduced (Std mean difference [SMD], −2.38; 95% CI, −3.40, −1.36; p < 0.01) in the minocycline group. Heterogeneity among the studies was proved to exist for infarct volume (Chi 2 = 116.12, p < 0.01; I 2 = 0.89) but not for other variables. Conclusions: Based on the results in our study, minocycline appears as an effective therapeutic option for acute ischemic stroke.
Author Zhang, Xin
Xia, Bin
Zheng, Wei
Sheng, Zhaofu
Li, Hongmin
Yong, V Wee
Liu, Yang
Xue, Mengzhou
AuthorAffiliation 2 The Henan Medical Key Laboratory of Translational Cerebrovascular Diseases , Zhengzhou , China
3 Hotchkiss Brain Institute, University of Calgary , Calgary, AB , Canada
4 Department of Clinical Neurosciences, University of Calgary , Calgary, AB , Canada
1 The Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University , Zhengzhou , China
AuthorAffiliation_xml – name: 4 Department of Clinical Neurosciences, University of Calgary , Calgary, AB , Canada
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– name: 2 The Henan Medical Key Laboratory of Translational Cerebrovascular Diseases , Zhengzhou , China
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  surname: Sheng
  fullname: Sheng, Zhaofu
  organization: The Henan Medical Key Laboratory of Translational Cerebrovascular Diseases, Zhengzhou, China
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  organization: The Henan Medical Key Laboratory of Translational Cerebrovascular Diseases, Zhengzhou, China
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  organization: The Henan Medical Key Laboratory of Translational Cerebrovascular Diseases, Zhengzhou, China
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30619060$$D View this record in MEDLINE/PubMed
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Keywords clinical study
meta-analysis
rodent study
minocycline
ischemic stroke
Language English
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Reviewed by: Konark Malhotra, Charleston Area Medical Center, United States; Adam Denes, Institute of Experimental Medicine (MTA), Hungary
Edited by: Heike Wulff, University of California, Davis, United States
This article was submitted to Stroke, a section of the journal Frontiers in Neurology
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Snippet This study aimed to assess the efficacy of minocycline for the treatment of acute ischemic stroke. While there have been meta-analysis that surveyed the...
Objectives: This study aimed to assess the efficacy of minocycline for the treatment of acute ischemic stroke. Background: While there have been meta-analysis...
Objectives: This study aimed to assess the efficacy of minocycline for the treatment of acute ischemic stroke.Background: While there have been meta-analysis...
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SubjectTerms clinical study
ischemic stroke
meta-analysis
minocycline
Neurology
rodent study
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Title Efficacy of Minocycline in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Rodent and Clinical Studies
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