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

Authors

Robert J Kaner, Sarah L O'Beirne, Amy Krambrink, Cathie Spino, He Sarina Yang, Yuan-Shan Zhu, Ronald G Crystal, Marshall J Glesby

Published in

Chronic obstructive pulmonary diseases (Miami, Fla.). Sep 30, 2026. Epub Sep 30, 2026.

Abstract

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.
To test the safety and tolerability of doxycycline in PLWH.
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).
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.
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).

PMID:
42852919
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

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