Drug could extend window for limiting stroke damage

Administering the antibiotic minocycline within 24 hours of a stroke significantly reduces brain damage and physical impairment, Israeli researchers reported today.

Researchers hope the drug, which also combats inflammation, might prolong the “golden window” during which strokes can be treated.

Clot-dissolving drugs – the gold standard for stroke treatment – must be administered to victims in the first three hours to be effective, and many patients do not receive them in time.

If the study can be replicated, “minocycline could be an important means of reducing the disabling effects of stroke,” said Dr. Steven V. Pacia, a neurologist at Lenox Hill Hospital in New York who was not involved in the study.

The findings, published in the journal Neurology, will not change clinical practice any time soon, noted Dr. John R. Marler, associate director for clinical trials at the National Institute of Neurological Diseases and Stroke. “They were looking for signs that it might be effective, and they concluded that it might be. We need a larger trial” to be sure, he said.

The drug’s anti-inflammatory properties might block damage to neurons from toxins released when other brain cells die, said Dr. Raymond A. Swanson of the University of California, San Francisco.

Dr. Yair Lampl and his colleagues at Tel Aviv University studied 152 men and women who suffered a stroke but arrived at the hospital too late for clot-dissolving therapy.

Half received minocycline an average of about 12 hours after their strokes and for five days afterward, while the rest received a placebo. Doctors and patients knew who had received the drug, but the neurologists evaluating their conditions later did not.

“The improvement was apparent within a week of the stroke,” Lampl said.

At the end of three months, those receiving minocycline did four times better on the National Institutes of Health stroke scale, which measures vision, facial palsy, movement and speaking ability.