Tests of airway function in detecting and monitoring treatment of obliterative bronchiolitis after lung transplantation

Chacon, R A; Corris, Paul A.; Dark, John H.; Gibson, G J

doi:10.1016/s1053-2498(99)00134-5

Cited by 20 publications

(7 citation statements)

References 20 publications

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“…Our current and previously reported data 29 therefore suggest that FVC and other tests such as FEF 25–75% may be useful end points for intervention studies in BOS. Previous open studies of azithromycin therapy, including work from our own centre have not reported FVC data 9–13 or focused on physiological measurements which reflect smaller airway function.…”

Section: Discussionsupporting

confidence: 68%

A randomised controlled trial of azithromycin therapy in bronchiolitis obliterans syndrome (BOS) post lung transplantation

Corris

Ryan

Small

et al. 2015

Thorax

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140

101

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BackgroundWe conducted a placebo-controlled trial of azithromycin therapy in bronchiolitis obliterans syndrome (BOS) post lung transplantation.MethodsWe compared azithromycin (250 mg alternate days, 12 weeks) with placebo. Primary outcome was FEV1 change at 12 weeks.Results48 patients were randomised; (25 azithromycin, 23 placebo). It was established, post randomisation that two did not have BOS. 46 patients were analysed as intention to treat (ITT) with 33 ‘Completers’. ITT analysis included placebo patients treated with open-label azithromycin after study withdrawal.OutcomeThe ITT analysis (n=46, 177 observations) estimated mean difference in FEV1 between treatments (azithromycin minus placebo) was 0.035 L, with a 95% CI of −0.112 L to 0.182 L (p=0.6). Five withdrawals, who were identified at the end of the study as having been randomised to placebo (four with rapid loss in FEV1, one withdrawn consent) had received rescue open-label azithromycin, with improvement in subsequent FEV1 at 12 weeks. Study Completers showed an estimated mean difference in FEV1 between treatment groups (azithromycin minus placebo) of 0.278 L, with 95% CI for the mean difference: 0.170 L to 0.386 L (p=<0.001). Nine of 23 ITT patients in the azithromycin group had ≥10% gain in FEV1 from baseline. No patients in the placebo group had ≥10% gain in FEV1 from baseline while on placebo (p=0.002). Seven serious adverse events, three azithromycin, four in the placebo group, were deemed unrelated to study medication.ConclusionsAzithromycin therapy improves FEV1 in patients with BOS and appears superior to placebo. This study strengthens evidence for clinical practice of initiating azithromycin therapy in BOS.Trial registration numberEU-CTR, 2006-000485-36/GB.

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Section: Discussionsupporting

confidence: 68%

A randomised controlled trial of azithromycin therapy in bronchiolitis obliterans syndrome (BOS) post lung transplantation

Corris

Ryan

Small

et al. 2015

Thorax

Self Cite

140

101

View full text Add to dashboard Cite

show abstract

“…Our current and previously reported data 29 therefore suggest that FVC and other tests such as FEF 25-75% may be useful end points for intervention studies in BOS. Previous open studies of azithromycin therapy, including work from our own centre have not reported FVC data [9][10][11][12][13] or focused on physiological measurements which reflect smaller airway function.…”

Section: Discussionsupporting

confidence: 67%

173 A Randomised Controlled Trial of Azithromycin Therapy in Bronchiolitis Obliterans Syndrome (BOS) Post Lung Transplantation

Corris

Small

Ryan

et al. 2012

The Journal of Heart and Lung Transplantation

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“…Previous study by Chacon et al (2000) showed that simple spirometry indices are useful for detection and evaluation of response to treatment of inpatients with BO due to lung transplantation. In our study the improvement in FEV1, FVC, PEF, and FEV1/FVC indices after 3 mo of therapy and their decrease to baseline values after a follow-up period in both groups is an indicator of reversibility of airway obstruction and usefulness of spirometry for their follow-up.…”

Section: Discussionmentioning

confidence: 99%

Inhaled Corticosteroids and Long-Acting β2-Agonists in Treatment of Patients with Chronic Bronchiolitis Following Exposure to Sulfur Mustard

Ghanei

Shohrati

Harandi

et al. 2007

Inhalation Toxicology

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We examined the role of two regimens of combination inhaler therapy on amount of reversibility of chronic lung complications in mustard gas exposed patients. In a phase III, prospective, randomized clinical trial, 105 participants received either combination form of fluticasone propionate and salmetrol, 500/100 microg daily (group 1; n = 52) or beclomethasone, 1000 microg daily, and salbutamol inhaler, 800 microg daily (group 2; n = 53) for 12 wk. Pulmonary function test (PFT) indices and respiratory symptoms (including dyspnea, night awakening due to dyspnea and cough) were assessed at baseline and in each visit. Thirty-six patients in group 1 and 30 patients in group 2 completed study course. Both medication regimes increased pretreatment forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC%, and peak expiratory force (PEF) by the end of 12 wk. It seems that these improvements are more constant in group 1 than in group 2. Reversibility, that is, 10% increase of FEV1 in the second month was seen for 27% of patients in the group 1 and for 7% in the group 2. VAS scores have decreased in two groups during treatment period (p = .003) and after follow-up period it remained sustained in group 1 alone. Inhaled corticosteroids and long-acting beta 2-agonists are effective in treatment of patients with chronic bronchiolitis following exposure to sulfur mustard. However, a medium dose of fluticasone/salmeterol has the same effect on the airways reversibility, rather than a very high dose of beclomethasone with only the short-acting beta-agonist.

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Tests of airway function in detecting and monitoring treatment of obliterative bronchiolitis after lung transplantation

Cited by 20 publications

References 20 publications

A randomised controlled trial of azithromycin therapy in bronchiolitis obliterans syndrome (BOS) post lung transplantation

A randomised controlled trial of azithromycin therapy in bronchiolitis obliterans syndrome (BOS) post lung transplantation

173 A Randomised Controlled Trial of Azithromycin Therapy in Bronchiolitis Obliterans Syndrome (BOS) Post Lung Transplantation

Inhaled Corticosteroids and Long-Acting β2-Agonists in Treatment of Patients with Chronic Bronchiolitis Following Exposure to Sulfur Mustard

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