ClinicalTrials.gg
RecruitingNCT07594314Updated May 27, 2026

Minocycline After Successful Endovascular Thrombectomy Recanalization in Acute Anterior Circulation Large Vessel Occlusion (ATTRACTION-MINOA)

A Phase 2/3 interventional study of Minocycline hydrochloride capsule and Placebo capsules of Minocycline hydrochloride capsules in Acute Ischemic Stroke, Vessel Occlusion and Endovascular Thrombectomy, sponsored by Xiang Luo. Recruiting at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-27.

Sponsored by Xiang Luo · Phase 2/3, Interventional, and Treatment

From the registry’s dates

  • Started May 2026; still recruiting 5 months later.
Phase
Phase 2/3
Study type
Interventional
Enrollment
860
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Endovascular thrombectomy (EVT) improves outcomes in patients with acute large vessel occlusion (LVO). However, despite successful recanalization rates exceeding 80%, fewer than 50% of patients achieve favorable functional outcomes at 90 days, indicating a high rate of futile recanalization. Potential mechanisms include no-reflow, reperfusion injury, and microcirculatory dysfunction, which are closely associated with post-recanalization neuroinflammation.

Minocycline is a second-generation tetracycline with pleiotropic neuroprotective effects, including inhibition of microglial activation, reduction of inflammatory mediators, suppression of matrix metalloproteinases, attenuation of oxidative stress, and preservation of blood-brain barrier integrity. Prior preclinical and clinical studies suggest that minocycline may improve neurological outcomes in acute ischemic stroke.

This study is a multicenter, prospective, double-blind, randomized controlled trial designed to evaluate the safety and efficacy of adjunctive minocycline in patients with acute anterior circulation LVO who achieve successful recanalization after EVT. The trial will assess whether early administration of minocycline improves functional outcomes and reduces futile recanalization.

Read the detailed description

This study is a multicenter, prospective, double-blind, randomized controlled trial designed to evaluate the safety and efficacy of adjunctive minocycline in patients with acute anterior circulation LVO who achieve successful recanalization after EVT. Eligible patients will be randomized in a 1:1 ratio to receive minocycline or placebo as soon as possible after randomization. Participants assigned to the intervention group will receive a loading dose of 200 mg of minocycline administered orally, followed by a maintenance dose of 100 mg every 12 hours for 4 days (total of 9 doses). Patients in the control group will receive a matching placebo according to the same schedule. For patients with swallowing dysfunction, administration via a feeding tube will be permitted. The primary outcome is the proportion of patients achieving a modified Rankin Scale (mRS) score of 0-1 at 90 days. A total of 860 participants (430 per group) will be enrolled.

02

Conditions studied

  • Acute Ischemic Stroke
  • Vessel Occlusion
  • Endovascular Thrombectomy
  • Anterior Circulation Brain Infarction
  • Minocycline

Keywords

  • Acute Ischemic Stroke
  • Endovascular Thrombectomy
  • Minocycline
  • Anterior Circulation Large Vessel Occlusion
03

In context

Ischemic Stroke

2,612 studies on the registry are indexed under Ischemic Stroke; 971 are open to participants now.

This study's planned enrollment of 860 is above the median of 120 across 1,776 interventional studies indexed under Ischemic Stroke.

Browse Ischemic Stroke studies →

Lead sponsor

Xiang Luo is the lead sponsor of 7 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age ≥18 years;
  2. Pre-stroke mRS score of 0-1;
  3. Time from symptom onset to randomization ≤24 hours, including wake-up stroke or unwitnessed stroke. Symptom onset is defined as the last known well time;
  4. Baseline NIHSS score of 6-25;
  5. ASPECTS ≥6 on non-contrast CT or DWI;
  6. Clinical symptoms attributable to acute occlusion at one of the following sites, confirmed by CTA, MRA, or DSA: intracranial internal carotid artery, M1 segment of the middle cerebral artery, or M2 trunk of the MCA;
  7. Successful recanalization defined as mTICI 2b-3 after mechanical thrombectomy, with no evidence of secondary embolization in non-target vessels; or spontaneous improvement to mTICI 2b-3 on diagnostic angiography prior to thrombectomy with no planned intervention;
  8. Ability of the patient or legally authorized representative to provide written .

Exclusion criteria

Exclusion Criteria:

  1. Acute intracranial hemorrhage on CT or MRI;
  2. Bilateral acute stroke or multiple intracranial large vessel occlusions;
  3. Isolated extracranial internal carotid artery occlusion;
  4. History of pseudomembranous colitis or antibiotic-associated colitis;
  5. Known allergy to tetracycline antibiotics, any component of the drug, radiocontrast agents, or nitinol materials;
  6. Known resistance to tetracycline antibiotics;
  7. Use of tetracycline antibiotics within 7 days prior to randomization;
  8. History of intracranial hemorrhage within the past 3 months, including intraparenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural hematoma, or epidural hematoma;
  9. Intracranial tumors, vascular malformations, or other space-occupying intracranial lesions;
  10. History of intracranial or spinal surgery within the past 3 months;
  11. History of major surgery or significant trauma within the past 1 month;
  12. Receipt of any of the following treatments within the past 3 months: systemic retinoic acid or androgen/antiandrogen therapy (e.g., anabolic steroids, spironolactone);
  13. count \<100 × 10⁹/L;
  14. Severe hepatic insufficiency, chronic hemodialysis, or severe renal insufficiency (defined as estimated \<30 mL/min or serum creatinine >265.2 μmol/L [3.0 mg/dL]);
  15. Women who are pregnant or lactating, or who have a positive pregnancy test prior to randomization;
  16. \<6 months (e.g., due to or severe cardiopulmonary disease);
  17. Participation in another interventional clinical trial that may affect outcome assessment;
  18. Any other condition that, in the investigator's judgment, makes the patient unsuitable for participation or poses significant risk (e.g., inability to understand or comply with study procedures or follow-up due to psychiatric, cognitive, or emotional disorders).
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
860 participants (estimated)

Study arms

  • Experimental
    Minocycline group

    Participants with successful recanalization (mTICI 2b/3) after endovascular thrombectomy will receive minocycline as soon as possible after randomization. A loading dose of 200 mg of minocycline administered orally, followed by a maintenance dose of 100 mg every 12 hours for 4 days (total of 9 doses). For patients with swallowing dysfunction, administration via a feeding tube will be permitted.

    Drug: Minocycline hydrochloride capsule

  • Placebo comparator
    placebo group

    Participants with successful recanalization (mTICI 2b/3) after endovascular thrombectomy will receive placebo as soon as possible after randomization. Placebo was administered in the same manner as minocycline group.

    Drug: Placebo capsules of Minocycline hydrochloride capsules

Interventions

  • 50 mg per capsule, containing 50mg of Minocycline Hydrochloride.

  • DrugPlacebo capsules of Minocycline hydrochloride capsules

    50 mg per capsule, containing 0mg of Minocycline Hydrochloride.

06

What researchers measure

Primary outcomes

  1. Excellent outcome

    Rate of modified Rankin scale (mRS) 0-1 at 90±7 days Defined as an modified Rankin Scale (mRS) score of 0 or 1. The mRS scores range from 0 (no symptoms) to 5 (severe disability) and 6 (death).

    Time frame: 90±7 days

Secondary outcomes

  1. Ordinal distribution of mRS

    The shift analysis of mRS at 90±7 days

    Time frame: 90±7 days

  2. Functional independence

    Rate of mRS 0-2 at 90±7 days

    Time frame: 90±7 days

  3. Ambulatory or bodily needs-capable or better

    Rate of mRS 0-3 at 90±7 days

    Time frame: 90±7 days

  4. Quality of life (EQ-5D-5L)

    The EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L) index score at 90±7 days The EQ-5D-5L is a standardized, preference-based measure of health-related quality of life covering five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each with five severity levels. The EQ-5D-5L index score typically ranges from less than 0 (health states worse than death) to 1.0 (full health), with higher scores indicating better quality of life.

    Time frame: 90±7 days

  5. Neurologic deficit (NIHSS score) changes

    The change of NIHSS score from baseline The NIHSS is a standardized clinical scale used to quantify neurologic impairment in stroke patients. The total score ranges from 0 to 42, with higher scores indicating more severe neurologic deficit. The outcome is defined as the change in NIHSS score from baseline, where a greater negative change reflects greater neurologic improvement.

    Time frame: 24±12 hours and 6±1 days

Other outcomes

  1. Symptomatic intracranial hemorrhage (sICH)

    Rate of sICH after randomization (Heidelberg Bleeding Classification)

    Time frame: 24±12 hours and 6±1 days

  2. All-caused mortality

    All cause mortality at 90±7 days

    Time frame: 90±7 days

  3. Any intracranial hemorrhage

    Rate of any intracranial hemorrhage after randomization (Heidelberg Bleeding Classification)

    Time frame: 24±12 hours and 6±1 days

  4. Adverse events and serious adverse events

    Incidences of adverse events and serious adverse events

    Time frame: 90±7 days

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Lu Y, Guan L, Wu J, Yang Q, Zhang M, Zhou D, Yang H, Pan Y, Wang L, Qiu B, Liu C, Wang Y, Yang Y, Zhou X, Qu H, Liao X, Liu L, Zhao X, Bath PM, Johnston SC, Amarenco P, Turc G, Shi FD, Wang Y, Wang Y; EMPHASIS Investigators. Efficacy and safety of minocycline in patients with acute ischaemic stroke (EMPHASIS): a multicentre, double-blind, randomised controlled trial. Lancet. 2026 Feb 14;407(10529):679-688. doi: 10.1016/S0140-6736(25)01862-8. Epub 2026 Jan 30. PubMed 41628627 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07594314
Lead sponsor
Xiang Luo
Responsible party
Xiang Luo (Principal Investigator, Tongji Hospital) — Sponsor-investigator
First posted
May 18, 2026
Start date
May 21, 2026
Primary completion
Dec 2028 (estimated)
Completion
Dec 2028 (estimated)
Last update
May 27, 2026

Study contacts

Xiang Luo
Contact
flydottjh@163.com
+86-13349893413
Xiang Luo
principal investigator · Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 450001

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Minocycline

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