(Press-News.org) ATS 2012, SAN FRANCISCO – Researchers in the United Kingdom have determined that azithromycin, a broad-spectrum antibiotic that also has anti-inflammatory properties, can be an effective treatment option for patients suffering from bronchiolitis obliterans syndrome (BOS), a life-threatening complication that occurs in the majority of patients following lung transplantation.
BOS is the leading cause of mortality after the first year following transplantation, and occurs in part when the body repeatedly rejects the transplanted lung tissue. The syndrome causes the airways to become narrow and obstructed, resulting in a progressive decline in lung function and, eventually, respiratory failure. The exact full causes of the syndrome are unknown.
The study will be presented at the ATS 2012 International Conference in San Francisco.
The researchers evaluated the potential benefits of azithromycin, a type of antibiotic known as a macrolide, which works by inhibiting the ability of infection-causing bacteria to divide and replicate.
"In open studies, we and others have noted an improvement in lung function in BOS patients treated with macrolide antibiotics," said study lead author Paul Corris, professor of thoracic medicine at Newcastle University. "Other studies have not observed lung function gain with macrolide therapy, and there have been no randomized trials to date in patients with BOS."
"In this randomized study, we wanted to determine if patients treated with the antibiotic had improved lung function compared to patients who were treated with placebo," he said.
For their study, the researchers recruited 46 lung transplant patients with BOS and randomized them to receive either azithromycin (250mg on alternate days)or placebo. During the course of the study, 13 patients either withdrew or were withdrawn from the study; data from those individuals were included in a separate intent-to-treat (ITT) report.
To measure respiratory function, the researchers used a common lung function measurement called FEV1 (forced expiratory volume in the first second), which measures the volume of air (in millimeters, or ml) that can be forcibly exhaled in one second after taking a deep breath. By comparing patients' FEV1 values at the beginning of the study to FEV1 measurements made during the 12-week follow-up period, the researchers were able to determine if the patients' lung function had improved after being treated with azithromycin.
At the conclusion of their study, the researchers found that the patients who completed the study had a significant improvement in FEV1, with a mean difference of 358ml from baseline to 12 weeks; by comparison, patients in the placebo group experienced declines in their FEV1 measurements.
"Our randomized trial has confirmed that azithromycin improves lung function in patients with BOS following lung transplantation and this translates to improved survival for such patients," Dr. Corris noted. "There are ongoing studies trying to elucidate how the drug works which may well give clues to other potentially effective therapies."
###
"A Randomised Controlled Trial Of Azithromycin Therapy In Bronchiolitis Obliterans Syndrome (BOS) Post Lung Transplantation" (Session D13, Wednesday, May 23, 8:15 a.m., Room 2002-2004, Moscone Center; Abstract 27714)
* Please note that numbers in this release may differ slightly from those in the abstract. Many of these investigations are ongoing; the release represents the most up-to-date data available at press time.
Abstract 27714
A Randomised Controlled Trial Of Azithromycin Therapy In Bronchiolitis Obliterans Syndrome (BOS) Post Lung Transplantation
Type: Scientific Abstract
Category: 17.02 - Transplantation: Clinical (CP)
Authors: P. Corris1, T. Small2, V. Ryan3, J. Lordan2, A.J. Fisher1, G. Meachery2, G. Johnson2, C. Ward3; 1Freeman Hospital/Newcastle University - Newcastle Upon Tyne/UK, 2Freeman Hospital - Newcastle Upon Tyne/UK, 3Newcastle University - Newcastle Upon Tyne/UK
Abstract Body
RATIONALE
BOS post lung transplantation has previously been regarded as irreversible. In open studies we and others (1) have noted an improvement in lung function in BOS patients treated with macrolide antibiotics. Other studies have not observed lung function gain with macrolide therapy (2,3), and there are no randomised trials.
METHODS. A prospective, single-centre randomised double blind placebo controlled study of Azithromycin (250mg on alternate days) or placebo, in lung transplant recipients with BOS. The primary outcome was change in FEV1 from baseline to 12 weeks.
RESULTS. Between November 2006 and December 2010 46 patients with BOS were randomised (23 Azithromycin, 23 placebo); randomisation was stratified for the presence of suppurative disease pre op and whether the patient had received single or bilateral lungs. Thirty-three patients completed the study (16 Azithromycin, 17 placebo), receiving 12 weeks of study treatment as randomised. All 46 patients received at least one dose of study treatment and were followed up for 12 weeks. The intention to treat (ITT) analysis reported here utilises FEV1 at the last pre-withdrawal observation for those 13 patients (7 Azithromycin, 6 placebo) who withdrew or were withdrawn from study treatment. All analyses are adjusted for baseline FEV1 and the randomisation stratification variables (4).
For the ITT population, the Azithromycin group had a mean gain in FEV1 from baseline of 37ml, 95% confidence interval (CI) for the change was −75ml to 140ml and the placebo group had a mean fall in FEV1 of 181ml, 95% CI for the change was −294ml to −69ml. The mean difference in the change in FEV1, Azithromycin minus Placebo, was 218ml and the 95% CI for the mean difference in the change was 60ml to 377ml (P=0.008). For study completers, the mean difference in the change in FEV1, Azithromycin minus Placebo, was 358ml and the 95% confidence interval for the mean difference in the change was 186ml to 530ml (P END
Study shows antibiotic improves respiratory function in lung transplant patients
2012-05-23
ELSE PRESS RELEASES FROM THIS DATE:
P. aeruginosa bacteria associated with increased hospitalizations in COPD patients
2012-05-23
ATS 2012, SAN FRANCISCO – Patients with chronic obstructive pulmonary disease (COPD) who become infected with the bacterium Pseudomonas aerguinosa are more likely to have worse clinical outcomes and experience more hospitalizations during the course of their disease than COPD patients who are not infected, according to researchers from Buffalo, N.Y.
The study will be presented at the ATS 2012 International Conference in San Francisco.
Bacterial bronchial infection plays a key role in the course of COPD, causing chronic inflammation as well as acute exacerbations of ...
Mortality rates decrease, chronic disease rates increase among HIV+ ICU patients
2012-05-23
ATS 2012, SAN FRANCISCO – The expanded use of antiretrovirals, potent drugs used to treat retroviral infections such as human immunodeficiency virus (HIV), has been linked to significant decreases in hospital mortality rates among severely ill HIV-positive(HIV+) patients nationwide, primarily due to a decrease in opportunistic infections, according to a new study by researchers at Stanford University. Despite these encouraging data, the study also revealed that in this population, chronic diseases and bloodstream infections are on the rise.
The study results will be presented ...
Breast MRI helps predict chemotherapy's effectiveness
2012-05-23
OAK BROOK, Ill. – Magnetic resonance imaging (MRI) provides an indication of a breast tumor's response to pre-surgical chemotherapy significantly earlier than possible through clinical examination, according to a new study published online in the journal Radiology.
Women with breast cancer often undergo chemotherapy prior to surgery. Research has shown that women who receive this treatment, known as neoadjuvant chemotherapy, are more likely to achieve breast conservation than those receiving chemotherapy after surgery.
Clinicians track a patient's response to neoadjuvant ...
Researchers uncover new ways sleep-wake patterns are like clockwork
2012-05-23
Researchers at New York University and Albert Einstein College of Medicine of Yeshiva University have discovered new ways neurons work together to ease the transition between sleep and wakefulness. Their findings, which appear in the journal Neuron, provide additional insights into sleep-wake patterns and offer methods to explore what may disrupt them.
Their study explored the biological, or circadian, clocks of Drosophila fruit flies, which are commonly used for research in this area. This is because it is relatively easy to find mutants with malfunctioning biological ...
Mayo Clinic urologists present findings at American Urological Association Annual Meeting
2012-05-23
ROCHESTER, Minn. -- Mayo Clinic researchers will present findings on prostate cancer risk, screening, treatment and other urological research at the annual meeting of the American Urological Association May 19-23 in Atlanta. Mayo Clinic urologists will also be available to provide expert comment for reporters covering the conference.
Mayo Clinic studies that will be presented and their embargo dates include:
No negative impact on overall survival from post-prostate surgery hormone therapy
Embargoed until 10:30 a.m. ET Monday, May 21
In a first-of-its-kind study ...
Treating pain with transplants
2012-05-23
A new study finds that transplanting embryonic cells into adult mouse spinal cord can alleviate persistent pain. The research, published by Cell Press in the May 24th issue of the journal Neuron, suggests that reduced pain results from successful integration of the embryonic cells into the host spinal cord. The findings open avenues for clinical strategies aimed not just at treating the symptoms of chronic debilitating pain, but correcting the underlying disease pathology.
There are two major classes of chronic pain: inflammatory pain that results from injury to tissue, ...
Why cutting sugar can control seizures: Scientists identify metabolic regulator of epilepsy
2012-05-23
A new study unravels a link between a protein that can modify cellular metabolism in the brain and seizure susceptibility. The research, published by Cell Press in the May 24th issue of the journal Neuron, may lead to the development of new treatments for epilepsy.
Epilepsy is a disorder characterized by seizures, unpredictable and abnormal bursts of electrical activity in the brain. Some cases of epilepsy are resistant to traditional drug treatments but can be improved by a "ketogenic" diet. This type of diet, which is very low in sugars and high in fat, forces neurons ...
Dollars and sense: Why are some people morally against tax?
2012-05-23
As the U.S. presidential election campaigns heat up, the economic debate is dominated by bailouts, austerity and, inevitably, taxation. Now a new study published in Symbolic Interaction asks why tax is such an important issue to voters and explores the moral ideas which underpin their views.
Americans are famously hostile to taxes even though they are not heavily taxed in comparison to Canadians and the British. In their study Dr Jeff Kidder and Dr Isaac Martin, from Northern Illinois University and the University of California-San Diego, explore how middle class feelings ...
Socioeconomics may affect toddlers' exposure to flame retardants
2012-05-23
DURHAM, N.C. -- A Duke University-led study of North Carolina toddlers suggests that exposure to potentially toxic flame-retardant chemicals may be higher in nonwhite toddlers than in white toddlers.
The study also suggests that exposure to the chemicals is higher among toddlers whose fathers do not have a college degree, a proxy measure of lower socioeconomic background.
Hand-to-mouth activity may account for a significant amount of the children's exposure to the contaminants, according to the study, which appears Wednesday in the journal Environmental Health Perspectives. ...
Taking solar technology up a notch
2012-05-23
The limitations of conventional and current solar cells include high production cost, low operating efficiency and durability, and many cells rely on toxic and scarce materials. Northwestern University researchers have developed a new solar cell that, in principle, will minimize all of these solar energy technology limitations.
In particular, the device is the first to solve the problem of the Grätzel cell, a promising low-cost and environmentally friendly solar cell with a significant disadvantage: it leaks. The dye-sensitized cell's electrolyte is made of an organic ...