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Stroke Research and Treatment
Volume 2013 (2013), Article ID 362961, 7 pages
http://dx.doi.org/10.1155/2013/362961
Research Article

Reducing Haemorrhagic Transformation after Thrombolysis for Stroke: A Strategy Utilising Minocycline

1Department of Neurology and Clinical Neurophysiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia and School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA 6009, Australia
2Department of General Medicine, Royal Perth Hospital, Perth, WA 6000, Australia
3Department of Neurology, Fremantle Hospital, Fremantle, WA 6160, Australia
4Stroke Unit, Swan District Hospital, Middle Swan WA 6056, School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA 6009, Australia
5Department of Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
6Stroke Unit, Swan District Hospital, Middle Swan, WA 6056, Australia
7Department of Neurology, Royal Perth Hospital, Perth WA 6000, School of Medicine and Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
8Data Analysis Australia, Nedlands, WA 6009, Australia

Received 26 January 2013; Accepted 10 March 2013

Academic Editor: Majaz Moonis

Copyright © 2013 David J. Blacker et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Haemorrhagic transformation (HT) of recently ischaemic brain is a feared complication of thrombolytic therapy that may be caused or compounded by ischaemia-induced activation of matrix metalloproteinases (MMPs). The tetracycline antibiotic minocycline inhibits matrix MMPs and reduces macroscopic HT in rodents with stroke treated with tissue plasminogen activator (tPA). The West Australian Intravenous Minocycline and TPA Stroke Study (WAIMATSS) aims to determine the safety and efficacy of adding minocycline to tPA in acute ischaemic stroke. The WAIMATSS is a multicentre, prospective, and randomised pilot study of intravenous minocycline, 200 mg 12 hourly for 5 doses, compared with standard care, in patients with ischaemic stroke treated with intravenous tPA. The primary endpoint is HT diagnosed by brain CT and MRI. Secondary endpoints include clinical outcome measures. Some illustrative cases from the early recruitment phase of this study will be presented, and future perspectives will be discussed.