Adjuvant doxycycline to enhance anti-amyloid effects: Results from the dual phase 2 trial

EClinicalMedicine
Anita D'SouzaParameswaran N Hari

Abstract

Although, doxycycline use is associated with improved outcomes in amyloidosis in retrospective studies, evidence from clinical trials is limited. This phase 2 trial of doxycycline (clinicaltrials.gov: NCT02207556) in newly diagnosed light chain (AL) amyloidosis enrolled 25 patients with systemic AL amyloidosis on treatment with doxycycline for 1 year along with chemotherapy. Outcomes of interest included mortality, organ response, and hematologic response rates at 1 year. The median age was 62 years, 64% were male, and 68% had the AL lambda subtype. Patients had Mayo 2012 stage 3 in 24% and stage 4 in 28%. Cardiac involvement was present in 60% of patients, renal involvement in 72%, and 60% patients had 3 or more organs involved. Target organ was cardiac in 14(56%), renal in 7(28%), hepatic in 1(4%) and soft tissue in 3(12%). At 1 year, mortality was 20% (95% confidence interval, 8.9-41.6%) and organ response was 36% (18-57%). Hematologic response in 1-year survivors was 100%, including 30% complete and 55% very good partial response. Autologous hematopoietic cell transplant was performed in 60%; among transplanted patients, day-100 transplant-related mortality was 0. Doxycycline use was safe and not attributed to any grade 2 o...Continue Reading

Associated Clinical Trials

Citations

Aug 1, 2020·Expert Opinion on Emerging Drugs·Rajshekhar Chakraborty, Suzanne Lentzsch
Jan 5, 2021·Current Opinion in Nephrology and Hypertension·Maria M Picken
May 14, 2021·Circulation Research·Jan M GriffinMathew S Maurer
May 17, 2021·Blood Cancer Journal·M Hasib Sidiqi, Morie A Gertz
Jul 3, 2021·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Gareth J Morgan
Aug 8, 2021·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Haruki Koike, Masahisa Katsuno
Dec 11, 2021·Hematology·Susan Bal, Heather Landau

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Methods Mentioned

BETA
pregnancy test

Clinical Trials Mentioned

NCT02207556

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Cardiac Amyloidosis

Cardiac amyloidosis is a myocardial disease characterized by extracellular amyloid infiltration throughout the heart. Discover the latest research on cardiac amyloidosis here.

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