# Efficacy of Minocycline Hydrochloride Aspiration Sclerotherapy for Symptomatic Simple Hepatic Cysts: Does Clinical Outcome Vary With the Number of Injections?

## TL;DR

This study compares single-dose and multiple-dose minocycline treatments for liver cysts, finding similar effectiveness with potential benefits for single-dose.

## Contribution

The study provides evidence that single-dose minocycline aspiration may be as effective as multiple doses for treating hepatic cysts.

## Key findings

- Single-dose minocycline achieved 80% clinical success and 96.5% cyst volume reduction.
- Multiple-dose minocycline showed 87.5% clinical success and 99.1% volume reduction.
- Symptom disappearance rates were 80% and 100% for single and multiple doses, respectively.

## Abstract

Background and aim

Minocycline hydrochloride (MINO) aspiration sclerotherapy has been reported as a therapeutic strategy for symptomatic simple hepatic cysts. However, treatment methods vary between studies, and the optimal frequency of MINO administration remains debated. This study aimed to compare the efficacy and safety of single-dose versus multiple-dose MINO aspiration sclerotherapy for symptomatic simple hepatic cysts, with clearly defined primary and secondary clinical outcomes.

Methods

This was a single-center retrospective study. Patients who underwent MINO aspiration sclerotherapy for symptomatic simple hepatic cysts at Fujigaoka Hospital from January 2017 to March 2023 were included. Participants were categorized into single- and multiple-dose MINO groups for comparison. Before admission, patients were informed of their respective treatment schedules by their attending physicians, and the number of MINO doses administered was determined as either a single or multiple doses.

Results

The single- and multiple-dose groups comprised five and eight cases, respectively. Clinical success rates were 80% (4/5) and 87.5% (7/8) in the single- and multiple-dose groups, respectively. The median cyst volume reduction rate was 96.5% (range, 93.0-99.1%) and 99.1% (range, 80.7-99.8%) in the single- and multiple-dose groups, respectively. Symptom disappearance rates were 80% (4/5) and 100% (8/8) in the single- and multiple-dose groups, respectively, with no significant difference. Adverse event (AE) rates were 60% (3/5) and 62.5% (5/8) in the single- and multiple-dose groups, respectively, with no statistically significant difference detected. The single-dose group tended to have a shorter median length of hospital stay (18 vs. 23 days); however, this difference was not significant.

Conclusions

Although the sample size was small, single-dose minocycline therapy showed outcomes that were not clearly inferior to those of multiple-dose treatment. It may also reduce AEs and shorten hospitalization, but larger studies are needed to confirm these findings. A single-dose regimen could be considered a treatment option in selected patients.