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Neomacrolides in the treatment of patients with severe asthma and/or bronchiectasis: a retrospective observational study
Therapeutic Advances in Respiratory Disease, 12/13/2011
Clinical Article
Coeman M et al. - 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 high-resolution CT 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.
Methods- In a retrospective observational cohort study, the authors 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.
- After 3–8 weeks of treatment with low-dose neomacrolides, 108 patients were available for evaluation.
- In asthma patients (n = 47), 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; p = 0.042) and had a longer duration of asthma (29 vs. 9 years; p = 0.052).
- In patients with bronchiectasis only (n = 61), symptom scores improved significantly.
- Responders (≥60% symptom score improvement) were older (61 vs. 53 years; p = 0.004), more frequently male (53% vs. 27%; p = 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 = 0.053).
- In multivariate logistic regression analysis, age and male gender were independent predictors for improvement in this group.
