Highlights
- •Decrease in high sensitivity C-reactive protein (hsCRP) from baseline to week 39 in the OPTIMIZE clinical trial was significantly larger in the azithromycin treated group than placebo.
- •No difference between the groups was seen in hsCRP at 78 weeks compared to baseline.
- •Calprotectin, myeloperoxidase, absolute neutrophil count and total white blood cell count showed no differences between groups at any time point.
- •The findings are consistent with a transient systemic immunomodulatory effect of azithromycin in children with new pseudomonas.
Abstract
Chronic azithromycin improves outcomes in cystic fibrosis (CF), but its mechanism
of action is unclear. The OPTIMIZE trial demonstrated improvement in time to first
pulmonary exacerbation in children with new Pseudomonas treated with azithromycin. Azithromycin effect on systemic markers of inflammation
over 18 months was assessed by change from baseline for high-sensitivity C-reactive
protein, myeloperoxidase, calprotectin and absolute neutrophil count in the OPTIMIZE
population. Subjects treated with chronic azithromycin or placebo had samples collected
at baseline, 39 and 78 weeks of treatment. In 129 subjects, a significant decrease
in high-sensitivity C-reactive protein was present at 39 weeks in the azithromycin
group compared to placebo, but no significant difference between the groups at 78
weeks. No differences in change from baseline in myeloperoxidase, calprotectin or
absolute neutrophil count were present at either time point. This supports the concept
of a transient immunomodulatory effect for chronic azithromycin therapy in children
with CF.
Keywords
Abbreviations:
ANC (absolute neutrophil count), DSMB (data safety monitoring board), hsCRP (high-sensitivity c-reactive protein), MPO (myeloperoxidase), Pa (Pseudomonas aeruginosa), PEx (pulmonary exacerbation), SAA (serum amyloid)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 05, 2022
Accepted:
February 25,
2022
Received in revised form:
February 24,
2022
Received:
October 21,
2021
Identification
Copyright
© 2022 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
