News from Medscape Pulmonary Medicine
NEW YORK (Reuters Health) Sept 15 - The long-term survival of lung transplant recipients is limited by the development of bronchiolitis obliterans syndrome (BOS), a condition thought to be irreversible, but UK researchers suggest that the drop in lung function can, in fact, be reversed through treatment with azithromycin (Zithromax).
Encouraging findings from a pilot study, led Dr. Paul A. Corris, from The Freeman Hospital in Newcastle upon Tyne, and colleagues to retrospectively evaluate the effects of azithromycin on lung function in 20 lung allograft recipients with established BOS.
Azithromycin was introduced at a mean of 82 months after transplantation, according to the report in the September issue of the American Journal of Respiratory and Critical Care Medicine. All of the subjects were treated with immunosuppressive regimens that included a cell-cycle inhibitor, oral corticosteroids, and a calcineurin inhibitor.
After 3 months of treatment, azithromycin therapy was tied to a 110 mL median increase in FEV1 (p = 0.002), the authors point out. Moreover, the majority of patients who experienced an early benefit showed sustained improvements at up to 11 months.
"This case series," the authors observe, "confirms the benefit of azithromycin in not only halting, but reversing the declining lung function seen in patients with BOS."
"Low-dose macrolides," they conclude, "offer a new and exciting therapeutic strategy for the treatment of progressive BOS, and further clinical and translational mechanistic studies are required."
Am J Respir Crit Care Med 2005;172:772-775.