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- Title
A randomised controlled trial of azithromycin therapy in bronchiolitis obliterans syndrome (BOS) post lung transplantation.
- Authors
Ladak, Shameem S.
- Abstract
Lung transplantation has proved to be successful in carefully selected individuals suffering from end stage lung diseases. However, post-lung transplant long-term graft survival is hindered by the development of bronchiolitis obliterans syndrome (BOS). This is characterised by airway obstruction due to progressive fibroblast proliferation and extracellular matrix deposition in the smaller airways ultimately leading to loss of lung function that is associated with decline in forced expiratory volume in 1 s (FEV1).Corris et al. conducted a single-centre randomised placebo-control trial to study the effect of azithromycin (over 12 weeks) in 46 lung transplant recipients with BOS. Lung function assessment was carried out at regular intervals for all patients recruited in nearly 4 years of study. The primary outcome was the change in FEV1. Azithromycin treatment lead to ≥10% gain in FEV1 from baseline in nine out 23 intention-to-treat patients. No significant gain in FEV1 was observed in the placebo group. However, out of 64 target patients, only 48 were randomised. Overall, three and four adverse incidents were observed, in the azithromycin and placebo group, respectively, that were independent of the study medication.This study suggested the therapeutic role of azithromycin in treatment of BOS and is the only randomised trial. Further study needs to be conducted to stratify patients with respect to risk of developing BOS and to determine the optimum treatment duration.
- Publication
Breathe, 2015, Vol 11, Issue 3, p230
- ISSN
1810-6838
- Publication type
Academic Journal
- DOI
10.1183/20734735.113115