The effect of doxycycline on abdominal aortic aneurysm growth: a meta-analysis

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Abstract Introduction There have been many studies on the benefits of chronic doxycycline therapy on slowing down the rate of abdominal aortic aneurysm (AAA) expansion by decreasing matrix metalloproteinase (MMPs) levels in AAA, known contributors to AAA growth. However, there have been few studies performed on the clinical effect of doxycycline on reducing the rate of AAA expansion. Purpose The objective of this meta-analysis was to evaluate the effect of doxycycline on the expansion of AAA. Methods We performed a comprehensive literature search using PubMed, Embase, and Cochrane Libraries from inception to October 2020 for all studies evaluating the effect of chronic doxycycline therapy on AAA growth. The primary outcome was the effect doxycycline therapy on AAA growth rate compared to the placebo. The mean difference and 95% confidence intervals (CI) were obtained by the Inverse Variance method within a random effect model. Results A total of three randomized control trials (485 total patients) were included in the final analysis. The analysis showed that there was no significant benefit of chronic doxycycline therapy in reducing AAA dilation rate compared to placebo [Mean difference of 0.03; 95% CI −0.05 to 0.11, P=0.43, I2=90%]. Conclusion This is the first meta-analysis evaluating the effects of chronic doxycycline therapy on the growth rate of AAAs. The current data suggests that there is no significant decrease in rate of expansion of AAA diameter in patients treated with chronic doxycycline vs. placebo. Funding Acknowledgement Type of funding sources: None.