Acne Medication Reduces Risk of a Demyelinating Event Developing into Multiple Sclerosis

Could an acne medication prove to be a viable treatment option for patients with early onset multiple sclerosis (MS)? After an unexpected discovery, scientists seem to think so.

Minocycline is a tetracycline antibiotic used to treat different bacterial infections, including severe acne, chlamydia and gonorrhea, and urinary tract infections.

In a study published in the New England Journal of Medicine, the investigators sought to determine whether minocycline reduces the risk of conversion from a first demyelinating event—–referred to as clinically isolated syndrome––to MS.

Included in the study were 142 patients with a mean age of 35.8 years, who experienced their first demyelinating symptoms within the prior 180 days. Each participant was randomized to receive either 100 mg of minocycline orally twice-daily or placebo, until a diagnosis of MS was established or until 24 months after treatment began.

The primary outcome was conversion to MS within 6 months after randomization. Secondary outcomes included conversion to MS within 24 months after randomization and changes on MRI at 6 and 24 months.

The results of the study showed that the risk of conversion to MS was 61% in the placebo arm and 33.4% in the minocycline arm—–a 27.6% reduction. All secondary MRI outcomes favored minocycline over placebo at 6 months, but not at 24 months.

“The clinical results are compelling,” said lead author Dr Luanne Metz. “Based on these findings, neurologists will be able to prescribe minocycline for people experiencing their first symptoms of demyelination if an MRI suggests the cause will likely prove to be MS.”

Currently, treatments in Canada for relapsing-remitting MS typical range from $20,000 to $40,000 per year. In the United States, cost can be triple the amount. Minocycline would cost a fraction of that at approximately $600 per year.

“Patients will now have yet another treatment option, one that does not require injections, monitoring lab work, or special authorization by their insurance company; provided they have adequate coverage to begin with,” Dr Metz said. “These processes can delay treatment initiation for 3 to 4 months whereas minocycline can be started immediately.”

There are no oral therapies approved in Canada for use at this very early stage of the disease. Current care for patients experiencing this involves an MRI at approximately 6 months to determine if the disease can be confirmed or treated with injectable medications to reduce the risk of their condition evolving to confirm MS.

“We have not cured MS, 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,” concluded study author V. Wee Yong, PhD.