Blood eosinophil count and GOLD stage predict response to maintenance azithromycin treatment in COPD patients with frequent exacerbations
Copyright © 2019 Elsevier Ltd. All rights reserved..
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% (x̄ = 1.26), compared to an eosinophil count < 2.0% (x̄ = 2.50; p = 0.02), GOLD stage 1-2 (x̄ = 1.06), versus GOLD stage 4 (x̄ = 2.62; p = 0.02) and GOLD group C (x̄ = 0.45) compared to group D (x̄ = 2.18; p < 0.01). Moreover, the number of hospitalizations was significantly lower in patients, with a blood eosinophil count ≥2.0% (x̄ = 0.26) compared to an eosinophil count < 2.0% (x̄ = 0.90; p = 0.01) and in GOLD stages 1-2 (x̄ = 1.06) compared to stage 4 (x̄ = 2.62; p = 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%.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:154 |
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| Enthalten in: |
Respiratory medicine - 154(2019) vom: 01. Juli, Seite 27-33 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Djamin, Remco S [VerfasserIn] |
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| Links: |
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| Themen: |
83905-01-5 |
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| Anmerkungen: |
Date Completed 15.07.2020 Date Revised 15.07.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.rmed.2019.06.005 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM298197030 |
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| 100 | 1 | |a Djamin, Remco S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Blood eosinophil count and GOLD stage predict response to maintenance azithromycin treatment in COPD patients with frequent exacerbations |
| 264 | 1 | |c 2019 | |
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| 500 | |a Date Revised 15.07.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier Ltd. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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% (x̄ = 1.26), compared to an eosinophil count < 2.0% (x̄ = 2.50; p = 0.02), GOLD stage 1-2 (x̄ = 1.06), versus GOLD stage 4 (x̄ = 2.62; p = 0.02) and GOLD group C (x̄ = 0.45) compared to group D (x̄ = 2.18; p < 0.01). Moreover, the number of hospitalizations was significantly lower in patients, with a blood eosinophil count ≥2.0% (x̄ = 0.26) compared to an eosinophil count < 2.0% (x̄ = 0.90; p = 0.01) and in GOLD stages 1-2 (x̄ = 1.06) compared to stage 4 (x̄ = 2.62; p = 0.04) | ||
| 520 | |a 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% | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Azithromycin | |
| 650 | 4 | |a COPD | |
| 650 | 4 | |a Eosinophils | |
| 650 | 4 | |a Exacerbations | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 650 | 7 | |a Macrolides |2 NLM | |
| 650 | 7 | |a Placebos |2 NLM | |
| 650 | 7 | |a Azithromycin |2 NLM | |
| 650 | 7 | |a 83905-01-5 |2 NLM | |
| 700 | 1 | |a Bafadhel, Mona |e verfasserin |4 aut | |
| 700 | 1 | |a Uzun, Sevim |e verfasserin |4 aut | |
| 700 | 1 | |a Russell, Richard E K |e verfasserin |4 aut | |
| 700 | 1 | |a Ermens, Anton A M |e verfasserin |4 aut | |
| 700 | 1 | |a Kerstens, Rene |e verfasserin |4 aut | |
| 700 | 1 | |a Aerts, Joachim G J V |e verfasserin |4 aut | |
| 700 | 1 | |a Pavord, Ian D |e verfasserin |4 aut | |
| 700 | 1 | |a van der Eerden, Menno M |e verfasserin |4 aut | |
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