TY - JOUR T1 - Azithromycin for the treatment of cough in idiopathic pulmonary fibrosis: A randomized controlled cross-over pilot trial JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.4567 VL - 56 IS - suppl 64 SP - 4567 AU - Manuela Funke-Chambour AU - Christian Clarenbach AU - Katrin Hostettler AU - Martin Brutsche AU - Thomas K. Geiser AU - Sabina A. Guler Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/4567.abstract N2 - 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.FootnotesCite 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). ER -