TY - JOUR T1 - Cryptogenic organizing pneumonia – Results of treatment with clarithromycin versus corticosteroids JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA3907 VL - 48 IS - suppl 60 SP - PA3907 AU - Elzbieta Radzikowska AU - Elzbieta Wiatr AU - Dariusz Gawryluk AU - Renata Langfort AU - Iwona Bestry AU - Piotr Rudzinski AU - Ewa Szczepulska-Wójcik AU - Kazimierz Roszkowski-Sliz Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA3907.abstract N2 - Corticosteroids are the standard treatment of cryptogenic organising pneumonia (COP), but macrolides are also effective. The aim of this study was to compare the results of clarithromycine (CAM) versus prednisone (PRE) treatment in patients with COP.Material and Methods: In a 15-year period, 44 patients were treated with CAM (500 mg b.d. orally, for 3 months) and 32 with PRE (mean dose of 0.73 ± 0.24 mg/kg/d for 8.68 ± 4.08 months).Results: The clinical presentation, laboratory, and radiological findings did not differ significantly between patients treated with CAM and PRE, with the exception of a higher frequency of sweats (59% vs. 25%; p < 0.014), ground glass opacities (95% vs. 69%; p < 0.001), and migratory pattern of lesions (73% vs. 50%; p < 0.043). Fewer cases of FEV1 of <80% (16% vs. 44%; p = 0.007) and hypoxemia (9% vs. 31%; p = 0.018) were noticed among patients treated with CAM. A complete response was achieved in 39 (93%) patients treated with CAM and in all treated with PRE. Patients treated with PRE more frequently than treated with CAM experienced relapse (53% vs. 7%; p < 0.0001). Corticosteroid-related adverse events were noticed in 53% of patients, but CAM caused only one (2%) allergic reaction. FVC >78% of predicted with sensitivity 79% and specificity 80% (AUC-0.931; 95%CI-0.81-1), and FEV1 > 63% of predicted with sensitivity 97% and specificity 60% (AUC-0.945; 95%CI-0.82-1) identified patients who might be successfully treated with CAM.CAM can be alternative treatment of COP, but in patients with pulmonary function parameters within the normal limits. This therapy is shorter, better tolerated, and associated with fewer adverse events and relapses than is PRE. ER -