PT - JOURNAL ARTICLE AU - Matthias Lavens AU - Guy Brusselle AU - Geert Verleden AU - Walter De Wever AU - Johan Coolen AU - Johny Verschakelen TI - Air-trapping on HRCT as a marker for patient outcome in severe asthmatics treated with azithromycin DP - 2014 Sep 01 TA - European Respiratory Journal PG - P656 VI - 44 IP - Suppl 58 4099 - http://erj.ersjournals.com/content/44/Suppl_58/P656.short 4100 - http://erj.ersjournals.com/content/44/Suppl_58/P656.full SO - Eur Respir J2014 Sep 01; 44 AB - Introduction: Add-on treatment with azithromycin reduces the rate of exacerbations and lower respiratory tract infections (LTRI) in specific phenotypes of severe asthma. High resolution CT (HRCT) determined air-trapping in asthmatic subjects identifies a group of individuals with a high risk of severe disease.Objectives: Can HRCT determined air-trapping predict clinical outcome of add-on treatment with azithromycin in severe asthmatics?Methods: 68 subjects with exacerbation prone severe asthma were randomized to placebo (n=32) or azithromycin (n=36) as add-on treatment to combination therapy of inhaled corticosteroids and long-acting β2 agonists. Two subgroups were defined according to the presence (n=43) or absence (n=25) of air-trapping on HRCT. The primary clinical outcome (PEP) is the rate of patients with severe exacerbations and LRTI requiring treatment with antibiotics during the 26-week treatment phase.Results: In the patient group without air-trapping on HRCT, there was a 26% absolute reduction in PEP rate (66% PEP rate in the intervention group with placebo and 40% PEP rate in the intervention group with azithromycin). In the patient group with HRCT determined air-trapping, PEP rates showed no benefit from azithromycin (42% PEP rate in the intervention group with placebo and 56% PEP rate in the intervention group with azithromycin).Conclusion: These data suggest a higher clinical response of add-on treatment with azithromycin in exacerbation prone severe asthma without air-trapping on high resolution CT.