Minocycline Does Not Decrease Geographic Atrophy Enlargement in AMD

MONDAY, March 25, 2024 (HealthDay News) — Oral minocycline is not associated with a decrease in geographic atrophy (GA) enlargement in patients with age-related macular degeneration (AMD), according to a study published online March 14 in JAMA Ophthalmology.

Tiarnan D. L. Keenan, B.M., B.Ch., Ph.D., from the National Eye Institute at the National Institutes of Health in Bethesda, Maryland, and colleagues conducted a phase 2, prospective, single-arm, nonrandomized trial to examine the safety and possible anatomic efficacy of oral minocycline, a microglial inhibitor, for the treatment of GA in AMD. Patients with GA from AMD in one or both eyes were recruited; they began 100 mg oral minocycline twice daily for three years after a nine-month run-in phase. Thirty-seven patients were enrolled and 36 initiated treatment.

The researchers found that 58 percent of the participants completed at least 33 months of treatment and 15 patients discontinued treatment. The mean square root GA enlargement rate in study eyes was 0.31 and 0.28 mm per year during the run-in and treatment phases, respectively. No difference was seen between the two phases in the secondary outcome measure of GA enlargement rate. Among 32 participants, there were 129 treatment-emergent adverse events recorded; 38 percent were related to minocycline.

“Given the potential disadvantages of existing therapeutic approaches, additional strategies remain desirable,” the authors write. “It may be necessary to elucidate more clearly the pathogenetic mechanisms underlying GA incidence and progression to develop therapies that target the underlying disease processes.”

Several authors disclosed ties to the pharmaceutical and medical device industries.

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