Oral minocycline therapy as first-line treatment in patients with Myalgic encephalomyelitis and long COVID: A pilot study, 2024, Miwa

Oral minocycline therapy as first-line treatment in patients with Myalgic encephalomyelitis and long COVID: A pilot study

Kunihisa Miwa

[In Press, Journal Pre-proof]

Background
Myalgic encephalomyelitis (ME) is associated with long COVID and also untoward sequelae after anti-coronavirus vaccination. Recently, oral minocycline therapy has been reported to ameliorate symptoms in patients with ME, particularly at the initial stage of the disease.

Methods
Oral minocycline (100 mg × 2 on the first day, followed by 100 mg/day for 41 days) was administered to 55 patients with ME that emerged during the “Corona era,” including 19 patients with long COVID and 5 patients diagnosed with untoward sequalae following coronavirus vaccination.

Results
Acute adverse effects including nausea and/or dizziness caused four (7 %) patients to discontinue treatment in the first few days. Among the other 51 patients who completed therapy, favorable effects were observed, including a decrease in performance status score or index for restricted activities of daily living ≥2 points in 41 (80 %) patients.

Disease duration was inversely associated with the favorable therapeutic effects (p = 0.02) and the disease duration within 6 months was significantly associated with the favorable therapeutic effects (27/30, 90 %, p = 0.02, hazard ratio: 3.6, 95 % confidence interval, 1.2–10.6).

The favorable effects were observed in 16 (89 %) of 18 patients with long COVID. Significant amelioration of subjective symptoms of fatigue, post-exertional malaise, unrefreshing sleep, brain fog, disequilibrium, orthostatic intolerance, and neuropathic pain were observed.

Conclusions
Oral minocycline was effective at ameliorating symptoms in patients with ME including long COVID and post-coronavirus vaccination sequalae. It represents an effective first-line therapeutic option for these patients in the initial stage.

Link | PDF (eNeurologicalSci) [Open Access]

 

I recall 15 years or so ago mentioning a similar phenomenon, but involving one of the tetracyclines' effect on MS, with one of my doctors. I seem to remembering him being dismissive and suggesting those MS patients probably were misdiagnosed. I didn't respond one way or the other, but I didn't agree.

 

Was there a control group? because otherwise this just fits with “natural recovery” trends.

 

I tried it. No effect on me. That was maybe 8-12 years into my ME, so not their "early stage" category. As Yann04 points out, the "early stage" category might simply be the category that has a natural remission rate ... that just happens to make their theory look good.

 

You can't really have a first line therapy if there is no second line therapy.
And there ain't.

 

It was mentioned in the first line of their text. I think that's what they must have meant.