PT  - JOURNAL ARTICLE
AU  - Remco S. Djamin
AU  - Sevim Uzun
AU  - Anton A.M. Ermens
AU  - Rene Kerstens
AU  - Henk C. Hoogsteden
AU  - Joachim G.J.V. Aerts
AU  - Menno M. van der Eerden
TI  - LATE-BREAKING ABSTRACT: Which predictors in COPD patients with the frequent exacerbator phenotype predict the treatment response to maintenance therapy with azithromycin?
AID  - 10.1183/13993003.congress-2016.PA3713
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA3713
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA3713.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA3713.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Background: It is unclear which COPD patients are most likely to benefit from long-term treatment with macrolides in order to reduce exacerbation frequency.Aims and objectives: We investigated which biomarkers and characteristics of COPD patients with frequent exacerbations have the best treatment response to maintenance therapy with azithromycin.Methods: This analysis was part of the COLUMBUS trial(Clinicaltrials.gov, NCT00985244), a randomized double-blind, placebo controlled, single-center trial, which investigated azithromycin maintenance therapy compared to placebo in 92 COPD patients with frequent exacerbations during 1 year. At baseline data for spirometry, white blood cell count, concentrations of CRP-reactive protein, mid-regional pro-adrenomedullin and sputum cultures were collected. Primary endpoint was the number of exacerbations in the year of treatment.Results: In the azithromycin group(n=47) a significant lower mean number of exacerbations was observed in patients with a level of serum eosinophils ≥2,0%(n=25; 1,24) compared to patients with serum eosinophils < 2,0%(n=22; 2,41) (p=0,01), in GOLD 1-2 patients(n=16; 1,06) compared to GOLD 3-4 patients(n=31; 2,16) (p=0,03) and GOLD C group(n=11; 0,45) compared to GOLD D group(n=34; 2,18) (p<0,01). In the placebo group(n=45) there were no significant differences between serum eosinophils groups(p=0,78), GOLD stages(p=0,15) or GOLD groups(p=0,48).Conclusions: In COPD patients with the frequent exacerbator phenotype a higher level of serum eosinophils, mild to moderate lung function impairment and fewer complaints show the best response to maintenance therapy with azithromycin.