Randomized Double-Blinded Pilot Study of Doxycycline for HIV-Associated COPD and Emphysema.

Publication Type Academic Article
Authors Kaner R, O'Beirne S, Krambrink A, Spino C, Yang H, Zhu Y, Crystal R, Glesby M
Journal Chronic Obstr Pulm Dis
Date Published 09/30/2026
ISSN 2372-952X
Abstract RATIONALE: Emphysema is prevalent in smoke-exposed people living with HIV. Matrix metalloproteinases are increased in bronchoalveolar lavage (BAL) fluid in People Living with HIV (PLWH) with emphysema. Doxycycline is an FDA-approved MMP-9 inhibitor, in addition to its antimicrobial properties. OBJECTIVES: To test the safety and tolerability of doxycycline in PLWH. METHODS: Single center double blind randomized placebo-controlled (2:1) pilot study of doxycycline 100 mg po twice daily in 27 PLWH who have COPD and/or emphysema (NCT01744093). MEASUREMENTS AND MAIN RESULTS: Doxycycline was safe and well-tolerated. There were robust serum and BAL fluid levels of doxycycline in individuals assigned to the doxycycline arm. Preliminary evidence of potential biologic effects of doxycycline in the lung included a reduction in BAL lung lymphocytes and a trend toward decreased MMP-9 activity. CONCLUSION: These data provide a rationale for a Phase II 72-week randomized placebo-controlled trial of doxycycline to slow the progression of emphysema in PLWH (NCT05382208).
DOI 10.15326/jcopdf.2026.0796
PubMed ID 42852919
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