Efficacy and Safety of Adjunctive Minocycline in the Treatment of Autoimmune Encephalitis (MEET): A Proof of Concept Study
Abstract
BACKGROUND: This study aims to determine whether 4 weeks of adjunctive minocycline can improve cognitive and neurological symptoms in patients with autoimmune encephalitis (AE). METHODS: In this randomized, open-label, blinded-endpoint trial, participants were randomized (1:1) to receive first-line immunotherapy with or without minocycline (100 mg twice daily for 4 weeks). Clinical outcomes included changes in the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), modified Rankin Scale (mRS), and Clinical Assessment Scale in Autoimmune Encephalitis (CASE). The exploratory outcome was the change in Soluble Triggering Receptor Expressed on Myeloid cells 2 (sTREM2), a biomarker of microglial activation. Follow-up assessments were conducted at weeks 4, 12, 24, and 48. RESULTS: Sixty patients with AE were enrolled. For the primary outcome, the difference in mean change in MoCA scores between the groups was 1.05 (P = 0.46) from baseline to week 12. However, at week 4, the minocycline group demonstrated significantly improvements in MoCA (difference, 3.85; 95% CI, 1.04 to 6.66; P = 0.008) and MMSE (difference, 3.23; 95% CI, 0.20 to 6.26; P = 0.037) compared to the control group. CSF sTREM2 levels decreased in the minocycline group (difference, –93.3; 95% CI, –186.60 to –0.05; P = 0.050). No other secondary outcomes differed between groups. Adverse events were mild, and no…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
Read the paper
Related studies
- Preliminary Toxicity Analysis of 3DCRT versus IMRT on the High Dose Arm of the RTOG 0126 Prostate Cancer Trial
- Adaptive Radiotherapy for Head and Neck Cancer: Initial Clinical Outcomes from a Prospective Trial
- American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology
- Motion Management Strategies and Technical Issues Associated with Stereotactic Body Radiotherapy of Thoracic and Upper Abdominal Tumors: A Review from NRG Oncology
- High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: treatment description and preliminary results of a phase I/II clinical trial
- Highly efficient training, refinement, and validation of a knowledge-based plan quality control system for radiotherapy clinical trials
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.