Systemic and functional effects of continuous azithromycin treatment in patients with severe chronic obstructive pulmonary disease and frequent exacerbations
Cuevas, Ester (Hospital Universitari de Bellvitge)
Huertas, Daniel (Consorci Sanitari Alt Penedès Garraf)
Montón, Concepción (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Marín, Alicia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Carrera-Salinas, Anna (Hospital Universitari de Bellvitge)
Pomares, Xavier (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Garcia-Nuñez, Marian (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Martí, Sara (Hospital Universitari de Bellvitge)
Santos, Salud (Hospital Universitari de Bellvitge)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	Continuous treatment with azithromycin may lead to fewer acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but little is known of its impact on systemic and functional outcomes in real-life settings. This was a multicenter prospective observational study of patients with severe COPD who started treatment with azithromycin. Tests were compared at baseline and after 3 and 12 months of treatment. These included lung function tests, a 6-min walking test (6MWT), and enzyme-linked immunosorbent assays of serum and sputum markers, such as interleukins (IL-6, IL-8, IL-13, IL-5), tumor necrosis factor receptor 2 (TNFR2), and inflammatory markers. Incidence rate ratios (IRR) and their 95% confidence intervals (95% CI) are reported. Of the 478 eligible patients, the 42 who started azithromycin experienced reductions in AECOPDs (IRR, 0. 34; 95% CI, 0. 26-0. 45) and hospitalizations (IRR, 0. 39; 95% CI, 0. 28-0. 49). Treatment was also associated with significant improvement in the partial arterial pressure of oxygen (9. 2 mmHg, 95% CI 1. 4-16. 9) at 12 months. While TNFR2 was reduced significantly in both serum and sputum samples, IL-13 and IL-6 were only significantly reduced in serum samples. Moreover, an elevated serum and sputum IL-8 level significantly predicted good clinical response to treatment. Continuous azithromycin treatment in a cohort of patients with severe COPD and frequent exacerbations can significantly reduce the number and severity of exacerbations and improve gas exchange. Treatment changes the pattern of microorganism isolates and decreases the inflammatory response. Of note, IL-8 may have utility as a predictor of clinical response to azithromycin treatment.
Grants:	Instituto de Salud Carlos III PI20/00777 Ministerio de Economía y Competitividad PI16/00977
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Azithromycin ; COPD ; Exacerbations ; Inflammatory markers ; Interleukins ; Microorganisms
Published in:	Frontiers in Medicine, Vol. 10 (july 2023) , ISSN 2296-858X

DOI: 10.3389/fmed.2023.1229463
PMID: 37554497

10 p, 1.7 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles