Minocycline in Multiple Sclerosis — Compelling Results but Too Early to Tell

Care for persons with multiple sclerosis has evolved as options for disease-modifying treatments have expanded. The high cost of current treatments1 has stimulated interest in repurposing existing, lower-cost drugs as new therapies for multiple sclerosis. One appealing candidate is minocycline, a relatively safe and inexpensive synthetic tetracycline that crosses the blood–brain barrier.2 Minocycline has antiinflammatory and antiapoptotic properties beyond its antibiotic activity. As an antiinflammatory agent, minocycline inhibits reactive microgliosis, production of interleukin-1β, up-regulation of inducible nitric oxide synthase, and activation of CD4+ T cells.35 As an antiapoptotic agent, the drug impedes cellular stress–mediated release of caspase-dependent and caspase-independent . . .