PUBLISHED: 4:09 PM on Wednesday, October 10, 2007
Trial will examine stroke medicine
AUGUSTA, Ga. - An antibiotic that showed remarkable success in limiting stroke damage in an Israeli study will soon be available in Augusta through a clinical trial at Medical College of Georgia. In a report published Tuesday in the journal Neurology, researchers at Tel Aviv University reported that patients given minocycline an average of 12 hours after a stroke showed half as much impairment 90 days later as those given a placebo. In fact, many of those treated showed little impairment at all on the National Institutes of Health Stroke Scale, a result that seemed a little too good to stroke researcher Dr. David Hess, chairman of the Department of Neurology at MCG.

"It's one of these studies that is probably too good to be true," he said. "I wish it was all true but I just tend to doubt that anything can work that well. It's hard to believe, it's so remarkable."

For instance, the drug was given between six and 24 hours after a stroke, but Hess and others found little effect from minocycline in animals after six hours.

Still, Hess believes it can do some good and has been working for years to start trials to treat patients with an IV version of the drug. He is awaiting Food and Drug Administration approval on the highest level dosage (they will test four levels) before beginning trials, perhaps in January. The stroke patients would be treated at MCG and the University of Kentucky in Lexington, he said. The three-year, $1.8 million NIH study is seeking to treat those who arrive within six hours of a stroke and Hess said many will also receive a clot-busting drug.

"That's important to know that the drug can be given with it, it's safe with it," he said.

Minocycline probably works in a couple of different ways. The Neurology authors believe it can block neurons from starting on the path to apoptosis, or programmed cell death. And it may also block inflammatory processes in the brain.

"And we think that when they get activated in stroke they actually damage neurons," Hess said. "I believe the drug works. I hope that study is right because that would be great for the stroke world and great for us. So I think that study is a beginning and I think it will help us push for a later study (in the U.S.)."