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Revista del Instituto de Medicina Tropical
versão impressa ISSN 1996-3696
Resumo
GONZALEZ, Nicolás et al. Randomized, double-blind, placebo-controlled study of doxycycline in patients with dengue. Cytokine modulation and clinical response. Rev. Inst. Med. Trop. [online]. 2022, vol.17, n.1, pp.23-34. ISSN 1996-3696. https://doi.org/10.18004/imt/2022.17.1.4.
Background:
Cytokine levels could be determinant in the severity of Dengue Fever. The suppression of their activity with immunomodulators would modify its evolution.
Objective:
To determine the effect of doxycycline on the cytokine profile of patients with dengue fever and to assess the clinical response and the impact on the severity of patients with dengue fever.
Materials and methods:
Randomized, double-blind, placebo-controlled study with doxycycline. Both groups received the medication for 7 days and clinical evolution, laboratory and cytokine levels were monitored on days 0, 3 and 7.
Results:
61 patients were included in the study, 36 (59%) in the placebo group and 25 (41%) in the doxycycline group. It was observed that patients treated with doxycycline showed lower thrombocytopenia at day 0 and 3 [(170029±47483/mm3 vs 198875±52211/mm3)(p<0.05) and 129545±62840/mm3 vs 165048±51142/mm3)(p<0.05)] when compared to the placebo group. IL-6, TNF and raIL-1 levels showed no significant differences. A trend to lower IL-1β levels was observed in the doxycycline treated group (52.1±97 vs 3.3±7.7)(0.08).
Conclusions:
There was no difference in clinical presentation, hospitalization or mortality among patients treated with doxycycline compared to placebo. There was a trend to lower IL-1β levels in patients treated with doxycycline. The sample size should be increased to confirm or reject the results.
Palavras-chave : cytokines; doxycycline; dengue fever.