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Repurposing an old drug to improve the use and safety of tissue plasminogen activator for acute ischemic stroke: minocycline

Hess, D.C.; Fagan, S.C.

Reviews in Neurological Diseases 7(Suppl 1): S7-13

2010

ISSN/ISBN: 1949-4378
PMID: 20410869
Document Number: 638182
There is only 1 US Food and Drug Administration-approved drug for acute ischemic stroke: tissue plasminogen activator (tPA). Due to a short time window and fear of intracerebral hemorrhage (ICH), tPA remains underutilized. There is great interest in developing combination drugs to use with tPA to improve the odds of a favorable recovery and to reduce the risk of ICH. Minocycline is a broad-spectrum antibiotic that has been found to be a neuroprotective agent in preclinical ischemic stroke models. Minocycline inhibits matrix metalloproteinase-9, a biomarker for ICH associated with tPA use. Minocycline is also an anti-inflammatory agent and inhibits poly (ADP-ribose) polymerase-1. Minocycline has been safe and well tolerated in the clinical trials conducted to date.

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