BACKGROUND:Chronic obstructive pulmonary disease (COPD) is characterized by airway inflammation and is associated with acute exacerbations. Macrolide antibiotics have been shown to exhibit anti-inflammatory effects in some chronic airway inflammatory diseases. OBJECTIVE: The aim of this study was to assess the effect of treatment with erythromycin on airway inflammation and health outcome in COPD patients. METHODS: We conducted a randomized, placebo-controlled, double-blind trial of erythromycin for a period of 6 months. Thirty-six COPD patients were randomized to treatment with oral erythromycin (125 mg, three times/day) or placebo. The primary outcomes were neutrophil number in sputum and exacerbations. RESULTS:Thirty-one patients completed the study. At the end of treatment, neutrophil counts in the sputum were significantly decreased in the group treated with erythromycin compared with placebo-treated patients (p = 0.005). Total cells in the sputum and neutrophil elastase in sputum supernatant were also significantly decreased in those treated with erythromycin compared with the placebo group (p = 0.021 and p = 0.024, respectively). The mean exacerbation rate was lower in the erythromycin group than in the placebo group (relative risk = 0.554, p = 0.042). Kaplan-Meier survival analysis showed that erythromycin significantly delayed the time to the first COPD exacerbation compared with placebo (p = 0.032). CONCLUSIONS:Erythromycin treatment in COPD patients can reduce airway inflammation and decrease exacerbations and may therefore be useful in the management of COPD.
RCT Entities:
BACKGROUND:Chronic obstructive pulmonary disease (COPD) is characterized by airway inflammation and is associated with acute exacerbations. Macrolide antibiotics have been shown to exhibit anti-inflammatory effects in some chronic airway inflammatory diseases. OBJECTIVE: The aim of this study was to assess the effect of treatment with erythromycin on airway inflammation and health outcome in COPDpatients. METHODS: We conducted a randomized, placebo-controlled, double-blind trial of erythromycin for a period of 6 months. Thirty-six COPDpatients were randomized to treatment with oral erythromycin (125 mg, three times/day) or placebo. The primary outcomes were neutrophil number in sputum and exacerbations. RESULTS: Thirty-one patients completed the study. At the end of treatment, neutrophil counts in the sputum were significantly decreased in the group treated with erythromycin compared with placebo-treated patients (p = 0.005). Total cells in the sputum and neutrophil elastase in sputum supernatant were also significantly decreased in those treated with erythromycin compared with the placebo group (p = 0.021 and p = 0.024, respectively). The mean exacerbation rate was lower in the erythromycin group than in the placebo group (relative risk = 0.554, p = 0.042). Kaplan-Meier survival analysis showed that erythromycin significantly delayed the time to the first COPD exacerbation compared with placebo (p = 0.032). CONCLUSIONS:Erythromycin treatment in COPDpatients can reduce airway inflammation and decrease exacerbations and may therefore be useful in the management of COPD.
Authors: Richard K Albert; John Connett; William C Bailey; Richard Casaburi; J Allen D Cooper; Gerard J Criner; Jeffrey L Curtis; Mark T Dransfield; Meilan K Han; Stephen C Lazarus; Barry Make; Nathaniel Marchetti; Fernando J Martinez; Nancy E Madinger; Charlene McEvoy; Dennis E Niewoehner; Janos Porsasz; Connie S Price; John Reilly; Paul D Scanlon; Frank C Sciurba; Steven M Scharf; George R Washko; Prescott G Woodruff; Nicholas R Anthonisen Journal: N Engl J Med Date: 2011-08-25 Impact factor: 91.245
Authors: P Zarogoulidis; N Papanas; I Kioumis; E Chatzaki; E Maltezos; K Zarogoulidis Journal: Eur J Clin Pharmacol Date: 2011-11-22 Impact factor: 2.953
Authors: Gerard J Criner; Jean Bourbeau; Rebecca L Diekemper; Daniel R Ouellette; Donna Goodridge; Paul Hernandez; Kristen Curren; Meyer S Balter; Mohit Bhutani; Pat G Camp; Bartolome R Celli; Gail Dechman; Mark T Dransfield; Stanley B Fiel; Marilyn G Foreman; Nicola A Hanania; Belinda K Ireland; Nathaniel Marchetti; Darcy D Marciniuk; Richard A Mularski; Joseph Ornelas; Jeremy D Road; Michael K Stickland Journal: Chest Date: 2015-04 Impact factor: 9.410
Authors: Dheeraj Gupta; Ritesh Agarwal; Ashutosh Nath Aggarwal; V N Maturu; Sahajal Dhooria; K T Prasad; Inderpaul S Sehgal; Lakshmikant B Yenge; Aditya Jindal; Navneet Singh; A G Ghoshal; G C Khilnani; J K Samaria; S N Gaur; D Behera Journal: Lung India Date: 2013-07