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Acne Drug Shown to Treat Early Multiple Sclerosis

Luanne Metz and Wee Yong

Luanne Metz, left, and Wee Yong (James May, University of Calgary)

2 June 2017. A clinical trial in Canada shows a common and inexpensive antibiotic to treat acne can reduce the chance early-stage multiple sclerosis becomes a full-blown disease. Results of the study led by researchers at University of Calgary in Alberta appear in yesterday’s issue of the New England Journal of Medicine (paid subscription required).

A team from the labs of neuroscientists Luanne Metz and V. Wee Yong are seeking more readily available and inexpensive options for treating multiple sclerosis, particularly in the early stages of the disease. Multiple sclerosis is an autoimmune condition where the immune system attacks the central nervous system and damages myelin, the fatty, protective substance around nerve fibers, as well as nerve cells themselves. Scar tissue from the damaged myelin, known as sclerosis, distorts the nerve signals sent to and from the brain and spinal cord, causing symptoms ranging from mild numbness to loss of vision or paralysis.

In this study, Metz, Yong, and colleagues from several institutions in Canada tested the drug minocycline, an antibiotic related to tetracycline for treating bacterial infections and inflammation on the skin, such as acne. The drug has a long history, with research dating back to the 1960s. The researchers became interested in minocycline as a possible multiple sclerosis treatment because of its anti-inflammatory properties, which were confirmed in tests with lab animals and early-stage clinical trials.

In the latest study, the researchers tested minocycline, taken as 100 milligram capsules, for treating multiple sclerosis in its early stages, a condition known as clinically isolated syndrome, where the first episodes of neurological symptoms occur. The late-stage clinical trial recruited 142 participants in Canada, age 18 to 60, with this type of multiple sclerosis. Participants were randomly assigned to take minocycline or a placebo twice a day for up to 2 years, or until full-fledged multiple sclerosis developed.

The team looked primarily for the progression of the disease in participants, from clinically isolated syndrome to full-scale multiple sclerosis in the first 6 months of treatment. The authors also tracked progress of the disease over 2 years, to determine if any early benefits were maintained, as well as the volume of lesions in the brain from multiple sclerosis.

The results show people with clinically isolated syndrome taking minocycline have a lower risk of progression into full-scale multiple sclerosis. Among participants receiving minocycline, the risk of progressing into multiple sclerosis after 6 months was 33 percent, compared to 61 percent for individuals taking a placebo. After 2 years, however, the risk of progression to multiple sclerosis between minocycline and placebo recipients narrowed to the point where differences were not large enough to be statistically reliable.

Some participants receiving minocycline reported more frequent adverse effects including rash, dizziness, and dental discoloration. More minocycline recipients also dropped out of the study than placebo recipients.

The authors consider results of the trial are encouraging because minocycline offers an oral drug for treating early-stage multiple sclerosis, where only injections were previously available. Another key factor is the drug’s low cost. In Canada, a course of minocycline treatment would cost $600 per year, compared to $20,000 to $40,000 per year for current drugs. In the U.S., say the researchers, multiple sclerosis drugs cost about 3 times as much as in Canada.

“We have not cured MS,” says Yong in a university statement, “but this trial makes future treatment easy and affordable.  It has global impact because there are countries where people with MS cannot be treated because of the very high cost.”

Yong and Metz tell more about the study in the following video.

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