Chest
Original Research: COPDClinical and Safety Outcomes of Long-Term Azithromycin Therapy in Severe COPD Beyond the First Year of Treatment
Section snippets
Subjects
A cohort of 505 patients with severe COPD (Global Initiative for Chronic Obstructive Lung Disease grade D) was routinely controlled and treated at the Respiratory Day Care Unit of Sabadell Hospital between January 2007 and December 2013. Patients treated with continuous cyclic azithromycin (CC-A) for repeated ECOPD (≥ 4 in the previous year) were recruited. The group of patients receiving this treatment for at least 24 months were considered LT-CC-A users and constituted the main target
Results
A total of 109 patients with severe COPD and ≥ 4 ECOPD in the previous year from the cohort of 505 patients controlled at the Respiratory Day Care Unit were eligible for CC-A therapy and agreed to participate in the study. The ST-CC-A group comprised 70 of the 109 participants (64.2%). The median (IQR) duration of azithromycin therapy in this group was 12 (10) months. Thirty-nine patients (35.8%) were treated for ≥ 24 months and constituted the LT-CC-A group, whose baseline variables are shown
Discussion
To our knowledge, this study is the first to examine the effectiveness and safety of LT-CC-A therapy over a 24-month period in patients with severe COPD with a history of frequent exacerbations. Regarding its effectiveness, CC-A therapy achieved a significant reduction in the number of ECOPD, an effect that endured beyond the first year of treatment and until the third year. These patients undergoing long-term treatment presented a reduction in ECOPD due to cPPMs, although they also presented a
Conclusions
This study examined the effectiveness and safety of LT-CC-A therapy over a 24-month period in patients with severe COPD who had frequent exacerbations. This therapy provided a clinical benefit in these patients, with a reduction in ECOPD that was maintained beyond the first year, throughout the second, and even during the third year of treatment, especially exacerbations due to cPPMs. However, there was a slight increase in the percentage of ECOPD due to P aeruginosa and other gram-negative
Acknowledgments
Author contributions: X. P. and C. M. are guarantors of the article; they were responsible for the design of the study, patient recruitment, treatment and follow-up, and writing of the manuscript. M. B. was responsible for patient recruitment, treatment follow-up, and data collection; O. C. performed the microbiologic tests and assessments; J. C. O. conducted the statistical analysis; and M. G. and E. M. were responsible for manuscript supervision.
Financial/nonfinancial disclosures: None
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Cited by (0)
Drs Pomares and Montón contributed equally to this manuscript and are co-first authors.