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Azithromycin for the treatment of cough in idiopathic pulmonary fibrosis: A randomized controlled cross-over pilot trial

Manuela Funke-Chambour, Christian Clarenbach, Katrin Hostettler, Martin Brutsche, Thomas K. Geiser, Sabina A. Guler
European Respiratory Journal 2020 56: 4567; DOI: 10.1183/13993003.congress-2020.4567
Manuela Funke-Chambour
1Department of Pulmonary Medicine, Inselspital, University Hospital and University of Bern, Bern, Switzerland
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  • For correspondence: manuelafunke@gmail.com
Christian Clarenbach
2Department of Pulmonary Medicine, University Hospital of Zürich, Zürich, Switzerland
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Katrin Hostettler
3Clinics of Respiratory Medicine, University Hospital of Basel, University Basel, Basel, Switzerland
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Martin Brutsche
4Department of Pulmonary Medicine, Kantonspital St. Gallen, St. Gallen, Switzerland
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Thomas K. Geiser
1Department of Pulmonary Medicine, Inselspital, University Hospital and University of Bern, Bern, Switzerland
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Sabina A. Guler
1Department of Pulmonary Medicine, Inselspital, University Hospital and University of Bern, Bern, Switzerland
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Abstract

Background: Idiopathic pulmonary fibrosis (IPF) patients suffer from chronic cough, reducing quality of life. Azithromycin (AZM) is an immunomodulatory and anti-inflammatory antibiotic. Retrospective studies suggest a role for AZM in reduction of acute IPF exacerbation.

Objective: To determine the effect of azithromycin on self-reported cough and quality of life in IPF.

Methods: We performed a double-blind randomized controlled cross-over trial with IPF patients undergoing two 12-week treatment periods (AZT 500mg 3 times/week or placebo). Primary outcome was change in cough-related quality of life measured by Leicester cough questionnaire (LCQ), cough severity was measured by Visual Analog Scale (VAS).

Results: Of 25 randomized patients (2 female, 23 male), 19 completed the study. Mean age was 67±8 years, FVC was 65±16%, and DLCO 43±16% predicted. Concomitant treatment included pirfenidone (36%), nintedanib (44%), and home oxygen therapy (36%). One patient died due to disease progression during the study, and two patients dropped out. Adverse effects were more frequently observed with AZM (nausea (16%), diarrhea (37%), abdominal pain (16%)). Neither LCQ scores [Difference after AZM: -0.64, 95%CI -1.53 to 0.25, p=0.15); Difference after placebo: 0.04, 95%CI -0.90 to 0.97, p=0.93] nor cough VAS [Difference after AZM: 0.21, 95% CI -1.05 to 1.46, p=0.73; Difference after placebo: 0.22, 95% CI-0.78 to 1.22, p=0.65] changed significantly with AZM.

Conclusion: Low dose AZT does not seem to improve patient reported cough severity and quality of life in patients with IPF, while adverse effects were more frequently observed.

  • Chronic diseases
  • Anti-inflammatory
  • RCT (Randomized Controlled Trial)

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4567.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2020
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Azithromycin for the treatment of cough in idiopathic pulmonary fibrosis: A randomized controlled cross-over pilot trial
Manuela Funke-Chambour, Christian Clarenbach, Katrin Hostettler, Martin Brutsche, Thomas K. Geiser, Sabina A. Guler
European Respiratory Journal Sep 2020, 56 (suppl 64) 4567; DOI: 10.1183/13993003.congress-2020.4567

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Azithromycin for the treatment of cough in idiopathic pulmonary fibrosis: A randomized controlled cross-over pilot trial
Manuela Funke-Chambour, Christian Clarenbach, Katrin Hostettler, Martin Brutsche, Thomas K. Geiser, Sabina A. Guler
European Respiratory Journal Sep 2020, 56 (suppl 64) 4567; DOI: 10.1183/13993003.congress-2020.4567
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