A common acne medicine called minocycline can reduce the rate of multiple sclerosis progression in patients who are at early stages of the disease, according to a Phase 3 clinical trial.
The finding was from the MinoCIS trial (NCT00666887) of minocycline, which goes by the brand name Mynocan and other labels. Canadian researchers published the study, “Trial of Minocycline in a Clinically Isolated Syndrome of Multiple Sclerosis,” in the New England Journal of Medicine.
“This study highlights the benefits of evaluating existing therapies for other indications,” Ruth Ann Marrie, a neurologist in Calgary, Canada, said in a press release. “Minocycline is an existing acne medication which is safe, and well-tolerated and it is available for immediate clinical use.”
The multicenter MinoCIS trial included 142 participants between the ages of 18 and 60 who displayed the first signs of what was suspected to be MS 180 days before starting treatment. The patients were randomized to receive either 100 mg of oral minocycline twice a day or a placebo.
After six months, researchers discovered that the risk of a patient’s disease progressing from a myelin-damage event to full-blown MS was half as low in the minocycline-treated group than in the placebo group — 33.4% versus 61.0%. The result was similar to what can be seen with MS therapies.
“The clinical results are compelling,” said Luanne Metz, the study’s lead author. She is a professor at the University of Calgary’s Cumming School of Medicine and an Alberta Health Services neurologist.
“Based on these findings, neurologists will be able to prescribe minocycline for people experiencing their first symptoms of demyelination if an MRI suggests the cause will likely prove to be MS.” Metz added.
The researchers said minocycline appears to help MS patients by reducing the inflammation that damages the natural protection of nerve cells, the myelin sheath. Damage to the sheath causes the first MS symptoms.
“Patients will now have yet another treatment option, one that does not require injections, monitoring lab work, or special authorization by their insurance company, provided they have adequate coverage to begin with,” Metz said. “These processes can delay treatment initiation for three to four months, whereas minocycline can be started immediately.”
One of the trial participants experienced the first signs of what might be MS before she was 27. She felt tingling in one of her hands, and numbness spread over half her body before an MRI scan confirmed the lesions in her brain and spine associated with MS. After two years in the trial, and taking the treatment after the trial ended, she is symptom-free and has not been diagnosed with MS.
This is just one of the success stories of this trial, researchers said.
“We have not cured MS, but this trial makes future treatment easy and affordable,” concluded Dr. V. Wee Yong, a Cumming School of Medicine professor who was an author of the study. “It has global impact because there are countries where people with MS cannot be treated because of the very high cost.”