Effect of azithromycin on bronchial wall thickness in severe persistent asthma: A double-blind placebo-controlled randomized clinical trial

Sadeghdoust, Mohammadamin; Mirsadraee, Majid; Aligolighasemabadi, Farnaz; Khakzad, Mohammad Reza; Attar, Amirhossein Hashemi; Naghibi, Saeed

doi:10.1016/j.rmed.2021.106494

Cited by 13 publications

(6 citation statements)

References 32 publications

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“…También, recientemente, se ha propuesto que la azitromicina puede tener una importante acción beneficiosa al evitar el remodelado bronquial aumentado tanto el diámetro como el área de la luz bronquial, aunque no se ha podido evidenciar que disminuya el grosor de la pared bronquial 112 . Se puede intentar tratamiento con azitromicina en pacientes mal controlados con triple terapia, especialmente si no reúnen criterios para un tratamiento biológico y cuando el objetivo terapéutico principal sean las exacerbaciones.…”

Section: Tratamiento Del Asma Graveunclassified

Documento de consenso de asma grave en adultos. Actualización 2022

Álvarez-Gutiérrez

Aparicio

Maldonado

et al. 2022

Open Respiratory Archives

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Section: Tratamiento Del Asma Graveunclassified

Documento de consenso de asma grave en adultos. Actualización 2022

Álvarez-Gutiérrez

Aparicio

Maldonado

et al. 2022

Open Respiratory Archives

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“…We then retrieved 118 articles for detailed evaluation. Subsequently, the 2 authors excluded 66 articles for failing to meet the eligibility criteria, thus leaving 52 articles in the systematic review and meta‐analysis 7,11,12,19‐67 (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Long‐Term Safety Profiles of Macrolides and Tetracyclines: A Systematic Review and Meta‐Analysis

Waitayangkoon,

Moon,

Tirupur Ponnusamy

et al. 2023

The Journal of Clinical Pharma

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Macrolides and tetracyclines are antibiotics that have a range of anti‐inflammatory properties beyond their microbial capabilities. Although these antibiotcs have been in widespread use, the long‐term safety profiles are limited. We performed a systematic review and meta‐analysis of randomized clinical trials (RCTs) that compared macrolides or tetracyclines with placeboes to provide long‐term safety information. We searched Medline and EMBASE from inception to October 2022 and identified studies that reported study‐drug‐related death, serious adverse events (SAEs), or withdrawal rates, and common adverse effects of each drug. Relative risk (RR) and number needed to harm (NNH) were calculated. Of the 52 RCTs included, there are 3,151 participants on doxycycline, 2,519 participants on minocycline, 3,049 participants on azithromycin, 763 participants on clarithromycin, 262 participants on erythromycin, and 100 participants on roxithromycin. There was no death related to any study drugs and rates of SAE were not significantly different from placebo in any drug. Overall withdrawal rates were slightly higher than placebo in doxycycline (RR, 1.30; 95% CI, 1.12‐1.52) and minocycline (RR, 1.29; 95% CI, 1.15‐1.46). Withdrawal rates due to adverse events were higher in doxycycline (RR, 2.82; 95% CI, 1.88‐4.22), minocycline (RR, 1.48; 95% CI, 1.09‐1.98), and azithromycin (RR, 1.53; 95% CI, 1.13‐2.08). Gastrointestinal (GI) disturbances are the most common tolerable adverse effects for every drug. Photosensitivity and rash are the second most common for doxycycline and minocycline. We found no evidence that long‐term use up to 2 years of macrolides or tetracyclines was associated with increased risk of SAEs.This article is protected by copyright. All rights reserved

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“…Two other studies found reduced eNO levels following macrolide treatment. Sadeghdoust et al found that both azithromycin and prednisolone induced a significant reduction in eNO levels in participants with severe asthma, where those receiving prednisolone had the most reduction in eNO [41]. Another study in children with mild asthma found that a 4‐week course of low‐dose clarithromycin—another macrolide—in combination with fluticasone both improved lung function as measured by FEV 1 and induced a significant reduction in eNO levels [42].…”

Section: Discussionmentioning

confidence: 99%

Exhaled nitric oxide is associated with inflammatory biomarkers and risk of acute respiratory exacerbations in children with HIV‐associated chronic lung disease

Flygel,

Hameiri‐Bowen,

Simms

et al. 2023

HIV Medicine

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ObjectivesChronic lung disease is a recognized complication in children with HIV. Acute respiratory exacerbations (ARE) are common among this group and cause significant morbidity. Exhaled nitric oxide (eNO) is a known marker of local airway inflammation. We investigated the association between eNO and ARE, biomarkers of systemic inflammation, and the effect of azithromycin on eNO levels.MethodsIndividuals aged 6–19 years with HIV‐associated chronic lung disease in Harare, Zimbabwe, were enrolled in a placebo‐controlled randomized trial investigating the effect of 48‐week azithromycin treatment on lung function and ARE. eNO levels and biomarkers were measured at inclusion and after treatment in a consecutively enrolled subset of participants. Linear regression and generalized linear models were used to study associations between eNO and ARE, biomarkers, and the effect of azithromycin on eNO levels.ResultsIn total, 172 participants were included in this sub‐study, 86 from the placebo group and 86 from the azithromycin group. Participants experiencing at least one ARE during follow‐up had significantly higher eNO levels at baseline than participants who did not (geometric mean ratio 1.13, 95% confidence interval [CI] 1.03–1.24, p = 0.015), adjusted for trial arm, age, sex and history of tuberculosis. Matrix metalloproteinase (MMP)‐3, ‐7, and ‐10 were significantly associated with higher baseline eNO levels. At 48 weeks, azithromycin treatment did not affect eNO levels (geometric mean ratio 0.86, 95% CI 0.72–1.03, p = 0.103).ConclusionHigher baseline eNO levels were a risk factor for ARE. eNO was associated with proinflammatory biomarkers previously found to contribute to the development of chronic lung disease. The potential use of eNO as a marker of inflammation and risk factor for ARE in HIV‐associated chronic lung disease needs further investigation.

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Effect of azithromycin on bronchial wall thickness in severe persistent asthma: A double-blind placebo-controlled randomized clinical trial

Cited by 13 publications

References 32 publications

Documento de consenso de asma grave en adultos. Actualización 2022

Documento de consenso de asma grave en adultos. Actualización 2022

Long‐Term Safety Profiles of Macrolides and Tetracyclines: A Systematic Review and Meta‐Analysis

Exhaled nitric oxide is associated with inflammatory biomarkers and risk of acute respiratory exacerbations in children with HIV‐associated chronic lung disease

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