Doxycycline Trial
Lymphangioleiomyomatosis (LAM) is a rare lung disease which affects women of child bearing age of all ethnic groups. Women with LAM develop enlarged air spaces in the lungs (cysts), caused by an excess of matrix metalloproteinases (MMPs), protein-digesting enzymes. LAM causes recurrent lung collapse, breathlessness and death or need for lung transplant and is also associated with kidney tumours, called angiomyolipomas. There is no proven treatment for LAM. Doxycycline, a commonly used antibiotic, can block MMP production and a small number of patients have shown some benefit from doxycycline. We will perform a study to test if doxycycline can slow the fall in lung function in patients with LAM.
Forty patients who consent to participate will take doxycycline or a placebo (dummy) tablet for two years in addition to their standard treatment. Participants will have breathing tests (lung function), tests of exercise capacity, quality of life, X-rays and blood tests at the start and throughout the study. The dose of doxycycline will be increased after one, two and three months and urine tests will be used to determine how much doxycycline is needed to stop MMP production. If patients have an unusually rapid fall in lung function during the study they will have the option of replacing the placebo with doxycycline or stopping doxycycline, as appropriate. Patients experiencing collapsed lung, bleeding from a kidney tumour or accumulation of fluid around the lung will be treated appropriately. The main measure used to test if doxycycline has been effective will be a comparison of the speed of decline of lung function in patients treated with doxycycline compared with placebo. We will also compare exercise capacity, quality of life, number of complications and side effects. This study may provide clear evidence for benefit of doxycycline in LAM or information with which to plan a larger study.
We need to raise £50,000 by December. To donate online to this appeal click here or send a cheque made to payable to "LAM Action" to
LAM Action
Doxycycline Appeal
Division of Respiratory Medicine
Clinical Sciences Building
City Hospital
Hucknall Road
Nottingham
NG5 1PB
If you are eligible gift aid and haven't filled in a gift aid form for LAM Action, you can download one here.
