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Neomacrolides in the treatment of patients with severe asthma and/or bronchiectasis: a retrospective observational study

Mathieu Coeman (UGent) , YANNICK VAN DURME (UGent) , Fre Bauters (UGent) , Ellen Deschepper (UGent) , Ingel Demedts (UGent) , Peter Smeets (UGent) , Guy Joos (UGent) and Guy Brusselle (UGent)
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Abstract
Rationale: Previous studies have demonstrated that long-term low-dose macrolides are efficacious in cystic fibrosis (CF) and diffuse panbronchiolitis, two chronic neutrophilic airway diseases. Aims: The aims of this study were to evaluate the efficacy and safety of low-dose neomacrolides as add-on therapy in patients with severe asthma and/or bronchiectasis and to identify predictors for therapeutic response. Methods: In a retrospective observational cohort study, we examined 131 adult, non-CF patients with severe asthma and/or bronchiectasis, receiving low-dose neomacrolides as add-on treatment. Pulmonary function tests and symptom scores were assessed at baseline and after 3 to 8 weeks of therapy. Results: After 3-8 weeks of treatment with low-dose neomacrolides, 108 patients were available for evaluation. In asthma patients (n¼47), pulmonary function tests and symptom scores improved significantly. Responders (>=7% forced expiratory volume in one second predicted [FEV1%] improvement) were older (55 vs. 47 years; p¼0.042) and had a longer duration of asthma (29 vs. 9 years; p¼0.052). In patients with bronchiectasis only (n¼61), symptom scores improved significantly. Responders (>=60% symptom score improvement) were older (61 vs. 53 years; p¼0.004), more frequently male (53% vs. 27%; p¼0.043), and there was a nonsignificant trend towards higher high-resolution CT (HRCT) score for bronchiectasis in responders (6.4 vs. 4.6; p¼0.053). In multivariate logistic regression analysis, age and male gender were independent predictors for improvement in this group. Conclusion: The results of this retrospective study suggest that neomacrolides may be useful as an add-on therapy in patients with severe asthma and/or bronchiectasis. Older age may predict good response in patients with severe asthma, whereas older age, male gender and a higher HRCT score for bronchiectasis may predict therapeutic response in patients with bronchiectasis only. Prospective controlled trials of neomacrolides in patients with severe asthma are needed to confirm these observations.
Keywords
bronchiectasis, asthma, neomacrolides

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Chicago
Coeman, Mathieu, YANNICK VAN DURME, Fre Bauters, Ellen Deschepper, Ingel Demedts, Peter Smeets, Guy Joos, and Guy Brusselle. 2011. “Neomacrolides in the Treatment of Patients with Severe Asthma And/or Bronchiectasis: a Retrospective Observational Study.” Therapeutic Advances in Respiratory Disease 5 (6): 377–386.
APA
Coeman, M., VAN DURME, Y., Bauters, F., Deschepper, E., Demedts, I., Smeets, P., Joos, G., et al. (2011). Neomacrolides in the treatment of patients with severe asthma and/or bronchiectasis: a retrospective observational study. THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE, 5(6), 377–386.
Vancouver
1.
Coeman M, VAN DURME Y, Bauters F, Deschepper E, Demedts I, Smeets P, et al. Neomacrolides in the treatment of patients with severe asthma and/or bronchiectasis: a retrospective observational study. THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE. 2011;5(6):377–86.
MLA
Coeman, Mathieu, YANNICK VAN DURME, Fre Bauters, et al. “Neomacrolides in the Treatment of Patients with Severe Asthma And/or Bronchiectasis: a Retrospective Observational Study.” THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE 5.6 (2011): 377–386. Print.
@article{2044797,
  abstract     = {Rationale: Previous studies have demonstrated that long-term low-dose macrolides are efficacious in cystic fibrosis (CF) and diffuse panbronchiolitis, two chronic neutrophilic airway diseases.
Aims: The aims of this study were to evaluate the efficacy and safety of low-dose neomacrolides as add-on therapy in patients with severe asthma and/or bronchiectasis and to identify predictors for therapeutic response.
Methods: In a retrospective observational cohort study, we examined 131 adult, non-CF patients with severe asthma and/or bronchiectasis, receiving low-dose neomacrolides as add-on treatment. Pulmonary function tests and symptom scores were assessed at baseline and after 3 to 8 weeks of therapy.
Results: After 3-8 weeks of treatment with low-dose neomacrolides, 108 patients were available for evaluation. In asthma patients (n{\textonequarter}47), pulmonary function tests and symptom scores improved significantly. Responders ({\textrangle}=7\% forced expiratory volume in one second predicted [FEV1\%] improvement) were older (55 vs. 47 years; p{\textonequarter}0.042) and had a longer duration of asthma (29 vs. 9 years; p{\textonequarter}0.052). In patients with bronchiectasis only (n{\textonequarter}61), symptom scores improved significantly. Responders ({\textrangle}=60\% symptom score improvement) were older (61 vs. 53 years; p{\textonequarter}0.004), more frequently male (53\% vs. 27\%; p{\textonequarter}0.043), and there was a nonsignificant trend towards higher high-resolution CT (HRCT) score for bronchiectasis in responders (6.4 vs. 4.6; p{\textonequarter}0.053). In multivariate logistic regression analysis, age and male gender were independent predictors for improvement in this group.
Conclusion: The results of this retrospective study suggest that neomacrolides may be useful as an add-on therapy in patients with severe asthma and/or bronchiectasis. Older age may predict good response in patients with severe asthma, whereas older age, male gender and a higher HRCT score for bronchiectasis may predict therapeutic response in patients with bronchiectasis only. Prospective controlled trials of neomacrolides in patients with severe asthma are needed to confirm these observations.},
  author       = {Coeman, Mathieu and VAN DURME, YANNICK and Bauters, Fre and Deschepper, Ellen and Demedts, Ingel and Smeets, Peter and Joos, Guy and Brusselle, Guy},
  issn         = {1753-4658},
  journal      = {THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE},
  keyword      = {bronchiectasis,asthma,neomacrolides},
  language     = {eng},
  number       = {6},
  pages        = {377--386},
  title        = {Neomacrolides in the treatment of patients with severe asthma and/or bronchiectasis: a retrospective observational study},
  url          = {http://dx.doi.org/10.1177/1753465811406771},
  volume       = {5},
  year         = {2011},
}

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