Blood eosinophil count and GOLD stage predict response to maintenance azithromycin treatment in COPD patients with frequent exacerbations.
Respir Med
; 154: 27-33, 2019.
Article
em En
| MEDLINE
| ID: mdl-31203097
ABSTRACT
INTRODUCTION:
Maintenance treatment with macrolides are useful in preventing COPD exacerbations. We investigated which characteristics of COPD patients with frequent exacerbations predicted the best response to maintenance treatment with azithromycin.METHODS:
This study was part of the COLUMBUS trial, a prospective randomized, double-blind, placebo-controlled study in 92 COPD patients with frequent exacerbations. During the 1-year treatment period, follow-up data were collected for spirometry, mMRC scores, sputum cultures and blood inflammatory markers.RESULTS:
In the azithromycin group a significant lower number of exacerbations per patient was observed in patients with the following characteristics baseline blood eosinophil count ≥2.0% (xÌâ¯=â¯1.26), compared to an eosinophil countâ¯<â¯2.0% (xÌâ¯=â¯2.50; pâ¯=â¯0.02), GOLD stage 1-2 (xÌâ¯=â¯1.06), versus GOLD stage 4 (xÌâ¯=â¯2.62; pâ¯=â¯0.02) and GOLD group C (xÌâ¯=â¯0.45) compared to group D (xÌâ¯=â¯2.18; pâ¯<â¯0.01). Moreover, the number of hospitalizations was significantly lower in patients, with a blood eosinophil count ≥2.0% (xÌâ¯=â¯0.26) compared to an eosinophil countâ¯<â¯2.0% (xÌâ¯=â¯0.90; pâ¯=â¯0.01) and in GOLD stages 1-2 (xÌâ¯=â¯1.06) compared to stage 4 (xÌâ¯=â¯2.62; pâ¯=â¯0.04).CONCLUSION:
In conclusion, azithromycin maintenance treatment appears to be effective in COPD patients with frequent exacerbations, who are either classified in GOLD stage 1-2 or GOLD C and those with a blood eosinophil count of ≥2.0%.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Azitromicina
/
Macrolídeos
/
Doença Pulmonar Obstrutiva Crônica
/
Eosinófilos
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Respir Med
Ano de publicação:
2019
Tipo de documento:
Article