Effects of Minocycline on Patients With Ischemic Stroke Undergoing Intravenous Thrombectomy (MIST-A)

Air Force Military Medical University of People's Liberation Army

Status and phase: Enrolling; Phase 4

Conditions: Ischemic Stroke, Acute

Treatments: Drug: Minocycline

Study type: Interventional

Funder types: Other

Identifiers

NCT05487417

XJLL-KY20222186

Details and patient eligibility

About

Minocycline is the second generation of tetracycline. Because of its lipophilicity, it has high penetrance of blood-brain barrier. Animal model studies have shown that minocycline can reduce cerebral damage after ischemic stroke, and its mechanism involves multiple molecular pathways, such as antioxidant, anti-inflammatory, anti apoptotic pathways, and protection of blood-brain barrier. Clinical studies have also shown that minocycline can significantly improve 3-month National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) of patients with ischemic stroke, indicating that minocycline is a potential neuroprotective drug. Minocycline is believed to protect the blood-brain barrier, thereby reducing the ischemia-reperfusion injury caused by mechanical thrombectomy. However, whether minocycline can become a synergistic treatment method of mechanical thrombectomy, there is no clinical research in this area at present. Therefore, investigators carry out the study on the effect of minocycline in patients with acute anterior circulation ischemic stroke after mechanical thrombectomy, and plan to enroll 180 patients. To explore the safety and effectiveness of minocycline in patients with acute ischemic stroke after thrombectomy.

Enrollment: 180 estimated patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients with acute cerebral infarction of anterior circulation accompanied by large vessel occlusion;
2. Age 18-85 years old;
3. The time of onset ≤ 6 hours or ≤ 24 hours suitable for mechanical thrombectomy determined by multimodal imaging;
4. The time of onset 6-24 hours, DWI shows an infarct volume less than 1/3 of the MCA blood supply area; the time of onset ≤ 6 hours, the ASPECTS(Alberta Stroke Program Early CT Score) is ≥6;
5. Preoperative NIHSS score ranges from 6 to 30 points;
6. Sign the informed consent form;

Exclusion criteria

1. There are contraindications for mechanical thrombectomy;
2. No revascularization therapy was performed during the operation or the TICI score after revascularization therapy was less than 2b;
3. There are other major central nervous system diseases, such as brain injury, brain tumor, multiple sclerosis, etc;
4. There is evidence that the patient has bacterial endocarditis, aortic dissection, arteritis or venous cerebral infarction;
5. Renal insufficiency or hepatic insufficiency (serum creatinine >2.0 mg/dL or 180 µmol/L; liver function greater than 3 times the normal value);
6. Known history of congestive heart failure (requiring dietary or medication changes or hospitalization) within 6 months, or myocardial infarction within 6 months;
7. There is evidence of any other life-threatening or severe diseases that may hinder the completion of the 3-month follow-up and affect the evaluation of the results;
8. Pre-existing neurological deficits or history of dementia;
9. There are infectious diseases that require antibiotic treatment before the disease;
10. Allergic to tetracyclines or unable to take minocycline for other reasons;
11. Minocycline could not be given within 1 hour after recanalization;
12. Pregnant patients;
13. Participated in another clinical trial within 30 days before inclusion in the study.
14. Refuse to sign the informed consent form.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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180 participants in 2 patient groups

Minocycline treatment group

Experimental group

Description:

Patients were given minocycline 200mg/d orally from the day of admission for 5 days. At the same time, the patient received mechanical thrombectomy and other standard treatments for acute ischemic stroke.

Treatment:

Drug: Minocycline

Routine treatment group

No Intervention group

Description:

Patients were given mechanical thrombectomy and other standard treatment for acute ischemic stroke, without minocycline treatment.