Trial of Roxithromycin in Subjects with Asthma and  Serological Evidence of Infection with<i>Chlamydia pneumoniae</i>

Black, Peter; Blasi, Francesco; Jenkins, Christine; Scicchitano, R.; Mills, Graham; Rubinfeld, Abe R.; Ruffin, Richard E.; Mullins, Peter R.; Dangain, Josette; Cooper, Bruce C.; Barastegui, David; Allegra, L.

doi:10.1164/ajrccm.164.4.2011040

Cited by 155 publications

(98 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There was a significant improvement in evening PEF by 6 weeks, but this was nonsignificant after 6 months' follow-up [49]. This was in direct contrast to a smaller study of KRAFT et al [48], who measured significant improvements in FEV1 only in asthmatics whose BAL fluid was PCR-positive for either M. pneumoniae or C. pneumoniae compared to PCR-negative subjects.…”

Section: Asthmacontrasting

confidence: 57%

“…Two studies have examined the effects of macrolide therapy in asthmatics with serological or PCR evidence of infection with Mycoplasma pneumoniae or Chlamydia pneumoniae. The largest study of BLACK et al [49] examined the effect of 6 weeks' roxithromycin or placebo treatment on 232 asthmatics with serological evidence of infection with C. pneumoniae. No significant change in the primary end-points of mean morning peak expiratory flow (PEF) or symptom score was observed.…”

Section: Asthmamentioning

confidence: 99%

“…The use of serology, by BLACK et al [49], to define infected and noninfected populations may have resulted in a dilution of subjects with true chronic infection with those previously exposed but not currently infected. By contrast, KRAFT et al [48] used PCR to define their populations and probably had a higher chance of delineating between truly infected and noninfected individuals.…”

Section: Asthmamentioning

confidence: 99%

See 2 more Smart Citations

Long-term macrolide therapy in chronic inflammatory airway diseases

Crosbie¹,

Woodhead²

2009

European Respiratory Journal

120

View full text Add to dashboard Cite

In addition to direct antibacterial actions, 14-and 15-member-ring macrolides have immune modulating effects that appear to be the reason for clinical benefit in diffuse panbronchiolitis.A literature search was conducted for studies of the clinical effectiveness of macrolides in other chronic lung conditions.A number of studies were identified that showed short-term beneficial outcomes or the potential for such outcomes in cystic fibrosis, bronchiectasis, chronic obstructive pulmonary disease, asthma and post-transplant obliterative bronchiolitis. The studies were limited by small patient numbers, different outcome measures and short-term follow-up, and were not designed to assess potentially harmful effects.Further large prospective and long-term studies are required in order to identify potential benefit and harm before these agents can be recommended routinely for these conditions.

show abstract

Section: Asthmacontrasting

confidence: 57%

Section: Asthmamentioning

confidence: 99%

Section: Asthmamentioning

confidence: 99%

See 1 more Smart Citation

Long-term macrolide therapy in chronic inflammatory airway diseases

Crosbie¹,

Woodhead²

2009

European Respiratory Journal

120

View full text Add to dashboard Cite

show abstract

“…Early studies have reported conflicting results [53][54][55][56][57]. Recently, SUTHERLAND et al [58] evaluated the effect of 16 weeks of either clarithromycin or placebo, added to fluticasone, on asthma control in individuals with or without lower airway PCR evidence of M. pneumoniae or C. pneumoniae.…”

Section: Asthmamentioning

confidence: 99%

Long-term macrolide treatment for chronic respiratory disease

2012

View full text Add to dashboard Cite

Long-term macrolide treatment was first shown to alter the natural history of diffuse panbronchiolitis (DPB) in the late 1980s. Since then, macrolides have been demonstrated to exert antiinflammatory and immunomodulatory activity in addition to being antimicrobial. Indeed, their spectrum of action extends to the regulation of leukocyte function and production of inflammatory mediators, control of mucus hypersecretion, resolution of inflammation and modulation of host defence mechanisms. As such, the potential benefit of macrolide antibiotics has been evaluated in a variety of chronic respiratory diseases. The best studied condition is cystic fibrosis, of which there have been six randomised controlled trials showing evidence of benefit. However, most of the studies were limited by small numbers of patients and short follow-up. More recently, landmark studies have demonstrated the efficacy of azithromycin in reducing the risk of acute exacerbations in patients with chronic obstructive pulmonary disease, but the optimal duration and dosing of macrolide treatment remain uncertain.With the exception of patients with DPB and cystic fibrosis, until clear evidence of efficacy is available, the long-term use of macrolides should be limited to highly selected patients after careful evaluation of benefit and harm, or in the context of randomised controlled clinical trials. @ERSpublications Several studies evaluating macrolide antibiotics for the treatment of chronic respiratory diseases are underway

show abstract

“…[17][18][19][20][21][22][23][24][25][26] A 2005 Cochrane review concluded that there was insufficient evidence to confirm or refute the role of macrolide treatment in chronic asthma. 1 Since 2005, 3 additional trials of macrolides in chronic adult asthma have reported patient-oriented outcomes.…”

Section: Previous Studiesmentioning

confidence: 99%

Azithromycin for Bronchial Asthma in Adults: An Effectiveness Trial

Hahn¹,

Grasmick²,

Hetzel³

et al. 2012

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

on behalf of the AZMATICS (AZithroMycin-Asthma Trial In Community Settings) Study GroupBackground: Macrolides have antimicrobial and anti-inflammatory properties that may be useful in the treatment of chronic asthma.Methods: We performed a randomized, placebo-controlled, double-blinded effectiveness trial of 12 weekly doses of adjunctive azithromycin, with follow-up to 1 year after randomization, in adults with persistent asthma. Measurements included overall asthma symptoms, asthma quality of life (AQL), and asthma control. Eligible subjects who declined to participate in randomization were offered enrollment into a parallel open-label (OL) azithromycin treatment arm.Results: Of 304 adult asthma patients screened, 97 (32%) were enrolled: 38 were randomized to azithromycin, 37 were randomized to placebo, and 22 opted in as OL subjects. OL subjects had higher rates of severe persistent asthma compared with randomized subjects (32% vs 8%, respectively; P ‫؍‬ .012). At 1 year, compared with the placebo arm, subjects randomized to azithromycin were more likely to have an AQL score >1 unit increase compared with baseline, but this difference was not statistically significant (36% vs 21% for placebo; P ‫؍‬ .335). Compared with placebo, OL subjects had significant improvements in overall asthma symptoms from baseline (P ‫؍‬ .0196), AQL (P ‫؍‬ .0006), and asthma control (P ‫؍‬ .0148).Conclusions: Adults with asthma who were randomized to azithromycin did not show statistically significant improvement in asthma outcomes, although the study was underpowered to detect clinical improvement in 15% (number needed to treat ‫؍‬ 7). Adults with severe persistent asthma who elected OL treatment documented clinical improvements in asthma symptoms, AQL, and asthma control that persisted after completion of OL azithromycin (number needed to treat ‫؍‬ 2). (J Am Board Fam Med 2012;25:442-459.)

show abstract

Trial of Roxithromycin in Subjects with Asthma and Serological Evidence of Infection withChlamydia pneumoniae

Cited by 155 publications

References 26 publications

Long-term macrolide therapy in chronic inflammatory airway diseases

Long-term macrolide therapy in chronic inflammatory airway diseases

Long-term macrolide treatment for chronic respiratory disease

Azithromycin for Bronchial Asthma in Adults: An Effectiveness Trial

Contact Info

Product

Resources

About