Adjunctive Treatment With Doxycycline to Enhance the Durability of Endovascular Aortic Aneurysm Repair

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00126204
Recruitment Status : Completed
First Posted : August 3, 2005
Last Update Posted : March 4, 2010
Information provided by:
Barnes-Jewish Hospital

Brief Summary:
The durability of endovascular aneurysm repair (EVAR) has been limited by development of endoleaks which may be secondary to progressive aortic degeneration by matrix metalloproteases (MMP). Doxycycline is a known inhibitor of the MMP family of enzymes in aneurysms. The investigators propose a randomized, controlled trial of adjuvant doxycycline therapy with EVAR to determine its effects on re-intervention, aneurysm shrinkage and serum markers of aneurysmal degeneration.

Condition or disease Intervention/treatment Phase
Aortic Aneurysm Drug: Doxycycline Not Applicable

Detailed Description:

Patients will be consented and enrolled at the time of their clinic visit or admission to the hospital for a planned EVAR, in accordance with institutional review board guidelines. Demographic, risk factor and medication regimen data will be obtained from the patient's clinical chart. Patients will be randomized to doxycycline therapy (100 mg taken twice daily) or a placebo. The patients will receive their first dose of study medication on the day following surgery, and continue the study therapy for 6 months.

Plasma and serum will be obtained at the time of enrollment (baseline), and at each post-operative follow-up visit during the study as outlined above. Aliquots will be stored at -80ºC until assayed. Measurements of the circulating markers will be performed by commercially available assays for plasma MMP-9 (R&D Systems, Minneapolis, MN), serum IL-6 (R&D Systems) , IL-8 (R&D Systems), IFN-gamma (R&D Systems), and CRP (Bio-Check, Burlingame, CA) Data will be collected from the pre-operative and all post-operative CT scans regarding maximal aneurysm diameter and transverse neck diameter at 5 mm, 10 mm and 15 mm below the takeoff of the lowest renal artery. All documented endoleaks and their clinical type will be recorded, as will any re-intervention related to the graft or aneurysm.

The primary end-points of the study related to aneurysm measurements will be an increase or decrease in any of the diameter measurements of the aorta by 2 mm or more on 2 consecutive CT scans or a change of 5 mm or more on any single scan. Of the circulating markers, an additional primary endpoint will be a 50% reduction in baseline MMP-9 after endografting. Secondary endpoints will be significant reductions over baseline in circulating IL-6, IL-8, IFN-γ, and CRP. An a priori power analysis indicates that at 6 months, reductions in circulating levels of these markers by 50% can be detected with a β-error of less than 0.1 and α-error of less than 0.05.

Study Type : Interventional  (Clinical Trial)
Enrollment : 75 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: Adjunctive Treatment With Doxycycline in Endovascular Aneurysm Repair
Study Start Date : March 2004
Study Completion Date : July 2006

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Primary Outcome Measures :
  1. Change in aortic measurements by > 2 mm on 2 consecutive scans
  2. Change in aortic measurement by > 5 mm on a single scan
  3. 50% reduction in baseline plasma MMP-9 at 6 months

Secondary Outcome Measures :
  1. Significant reductions at 6 months in serum interleukin-6 (IL-6)
  2. Significant reductions at 6 months in serum IL-8
  3. Significant reductions at 6 months in serum interferon-gamma
  4. Significant reductions at 6 months in serum C-reactive protein

Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Presence of an abdominal aortic aneurysm (AAA) with a maximum diameter of > or = 4.5 cm
  • Planned aneurysm exclusion with endoluminal stent graft (any brand)

Exclusion Criteria:

  • Known malignancy not to include prostate cancer or any history of cancer that has not had a recurrence in the last 5 years.
  • Hypersensitivity to doxycycline or any of its components
  • Pregnancy
  • Ruptured AAA
  • Extension of covered portion of the graft above the renal arteries
  • Previous endoluminal aneurysm repair

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00126204

United States, Missouri
Washington University School of Medicine / Barnes-Jewish Hospital
St. Louis, Missouri, United States, 63110
Sponsors and Collaborators
Barnes-Jewish Hospital
Principal Investigator: John A Curci, MD Washington University School of Medicine

Publications of Results: Identifier: NCT00126204     History of Changes
Other Study ID Numbers: 00012-0904-02
First Posted: August 3, 2005    Key Record Dates
Last Update Posted: March 4, 2010
Last Verified: September 2006

Keywords provided by Barnes-Jewish Hospital:
matrix metalloproteinase
circulating markers

Additional relevant MeSH terms:
Aortic Aneurysm
Vascular Diseases
Cardiovascular Diseases
Aortic Diseases
Anti-Bacterial Agents
Anti-Infective Agents
Antiprotozoal Agents
Antiparasitic Agents