@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 (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.}},
  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}},
  keywords     = {{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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