Evidence map›Paper›PMID 42749907›Full record

ReviewNeuroradiology2026

Minocycline for neuroprotection in stroke and cerebral ischemia: a systematic review and meta-analysis.

Omar Fayez Abbas, Aya Magdy Siam, Abdullah Almarfadi, Nour Aldin T Ahmed, Roaa Haddad, Ahmed Harb, Hannah Hurtig, Hasan Banihani, Mohamed Hamouda, Abdelrahman M Hamouda and 4 more

Abstract readReview
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In one paragraph

Review in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Omar Fayez AbbasFaculty of Medicine, Al Azhar University, Cairo, Egypt. omarfayez0007@gmail.com.ORCID http://orcid.org/0009-0003-5255-892X
Aya Magdy SiamKasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt.
Abdullah AlmarfadiFaculty of Medicine, Ferhat Abbas University of Setif, Sétif, Algeria.
Nour Aldin T AhmedFaculty of Medicine, Beni-Suef University, Banī Suwayf, Egypt.
Roaa HaddadFaculty of Medicine, October 6 University, Giza, Egypt.
Ahmed HarbFaculty of Medicine, Al Azhar University, Cairo, Egypt.
Hannah HurtigDepartment of Neurologic Surgery, Rochester, Minnesota, USA.
Hasan BanihaniDepartment of Neurologic Surgery, Rochester, Minnesota, USA.
Mohamed HamoudaFaculty of Biomedical Sciences, Galala University, Suez, Egypt.
Abdelrahman M HamoudaDepartment of Neurologic Surgery, Rochester, Minnesota, USA.
Sherief GhozyDepartment of Radiology, Rochester, Minnesota, USA.
Ram KadrivelDepartment of Radiology, Rochester, Minnesota, USA.
Kogulavadanan ArumathuraiDepartment of Neurology, Rochester, Minnesota, USA.
David F KallmesDepartment of Radiology, Rochester, Minnesota, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStroke remains a leading cause of mortality and long-term disability worldwide, with substantial socioeconomic and healthcare burdens. Minocycline, a tetracycline antibiotic with anti-inflammatory and antioxidant properties and the ability to cross the blood-brain barrier, has emerged as a potential neuroprotective agent in acute ischemic stroke (AIS). However, clinical evidence remains inconsistent. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of minocycline in patients with AIS.

methodsWe systematically searched PubMed, Scopus, Web of Science, and the Cochrane Library from inception to February 2026 for randomized controlled trials (RCTs) evaluating minocycline in adults with AIS. The primary outcomes were functional outcomes assessed using the modified Rankin Scale (mRS) and neurological outcomes assessed using the National Institutes of Health Stroke Scale. Dichotomous outcomes were pooled as risk ratios (RRs), while continuous outcomes were synthesized as mean differences (MDs), each with 95% confidence intervals (CIs), using random-effects meta-analysis with restricted maximum likelihood estimation. The Hartung-Knapp-Sidik-Jonkman adjustment was applied.

resultsSeven RCTs comprising 2,242 patients (1,113 receiving minocycline and 1,129 receiving placebo) were included. Minocycline was not associated with a statistically significant difference in continuous mRS scores at 90 days (MD = - 0.88; 95% CI: -4.03 to 2.28; p = 0.18; I² = 53.2%). Similarly, minocycline did not significantly improve excellent functional outcome (mRS 0-1) (RR = 1.09; 95% CI: 0.95-1.26; p = 0.14; I² = 0%) or functional independence (mRS 0-2) (RR = 1.05; 95% CI: 0.69-1.59; p = 0.76; I² = 65.2%). Similarly, minocycline was not associated with a statistically significant reduction in NIHSS scores at 90 days (MD = - 2.52; 95% CI: -5.37 to 0.33; p = 0.06) or improvement in BI scores (MD = 8.13; 95% CI: -29.32 to 45.58; p = 0.22). No significant differences were found in stroke recurrence (RR = 1.07; 95% CI: 0.70-1.61; p = 0.58) or mortality (RR = 0.69; 95% CI: 0.40-1.20; p = 0.12).

conclusionsMinocycline did not demonstrate a statistically significant improvement in functional or neurological outcomes at 90 days compared with the control group. The available evidence suggests no significant increase in stroke recurrence or mortality. Further large-scale, high-quality RCTs are warranted to clarify the potential neuroprotective effects of minocycline and determine its role in the routine management of AIS.

Indexed as

Cerebral IschemiaMinocyclineNeuroprotectionStroke

Identifiers

PMID42749907

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.