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Kidney weights were increased in both species but histological correlates were only observed in monkeys (tubular degeneration/regeneration [mainly diffuse], and interstitial oedema in the medulla were observed in both studies; there was no evidence of tubular necrosis). Increases in blood urea were observed in the 4 week monkey study which may have been associated with effects on the kidney and/or an anti-anabolic effect (due to a reduction in protein synthesis). The NOEL for kidney lesions was 5 mg/kg/day orally (PO) (ERAUC 0.8). Given the low safety margin, there is a potential for renal effects in patients treated for rosacea at the proposed dose. In rats, additional organs affected by doxycycline treatment include the adrenals (increased incidence of minimal cortical lipidosis) and, in the 6 month study only, the pharynx (minimal inflammatory cell infiltrate), while the spleen (reduction in the incidence of extramedullary haematopoiesis) was only affected at 600 mg/kg/day PO. Red blood cells were also affected in both studies in rats, with reductions in red cell numbers, and associated parameters (haemoglobin and haematocrit). The reduction in the incidence of extramedullary haematopoiesis in the spleen may have contributed to this finding at 600 mg/kg/day but red cell parameters were also reduced at lower doses (¡Ý200 mg/kg/day). The NOEL for all of these effects was 20 mg/kg/day (ERAUC 1.7). |
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