Commonly prescribed antibiotic reduces acute COPD attacks
An NIH-funded study has found that a commonly prescribed antibiotic lowers the frequency and severity of chronic obstructive pulmonary disease (COPD) flare-ups. The study results, which appear in the New England Journal of Medicine, show azithromycin may reduce the burden of COPD and improve the quality of life for patients.
Balintfy: Chronic obstructive pulmonary disease or COPD is a disease of the lungs that makes it harder and harder to breath over time. Dr. James Kiley at the National Institutes of Health says COPD is now the third leading cause of death in the United States.
Kiley: It is estimated that 12 million people have COPD; and probably what is even more revealing is that maybe another 12 million people have it but they donít even know it. So we have a prevalence of almost 24 million people with this disease and it is one that kills a lot of people.
Balintfy: Part of the problem is exacerbations or flare-ups, which are sudden onsets of worsened symptoms, including cough, wheeze, and labored breathing. Dr. Kiley explains that many patients, particularly those who have more severe COPD, will have relatively regular exacerbations especially during flu season. He adds that some exacerbations can lead to hospitalizations.
Kiley: Severe acute exacerbations of chronic obstructive pulmonary disease are oftentimes devastating. They can be life-threatening. So anything you can do to try to reduce the numbers of those acute exacerbations would be very, very important from a health, quality of life, and economic as well the overall lifesaving kinds of measures.
Balintfy: There is currently no cure for COPD, though a combination of drugs and lifestyle changes can help manage the symptoms. And now, a new study is showing that adding a common antibiotic to the usual daily treatment regimen for COPD can reduce the occurrence of acute exacerbations and improve quality of life.
Kiley: And we think that it is a very important finding because it's a first time that we've been able to show on a large clinical trial that adding this antibiotic to usual care treatment regimen improves overall quality of life, reduces symptoms, and keeps people out of the hospital.
Balintfy: The clinical trial included more than one-thousand participants. The antibiotic is azithromycin.
Kiley: It's called a macrolide antibiotic. It's in a class of drugs that's used for other things like strep throat and other kinds of infections. The interesting piece of this study that adds a little bit more is that besides the antimicrobial effects of this antibiotic, there have been suggestions that it may have anti-inflammatory type of properties.
Balintfy: Dr. Kiley explains that those anti-inflammatory properties are helpful because in the lungs of patients who have COPD there's some ongoing inflammation. But he warns that more research is needed to identify more approaches, strategies, and treatment interventions that will address this disease.
Kiley: We still have a long way to go. I mean the issue here is what can we do to address the mechanisms underlying the properties that this agent provides? We've got a bit more research to do before we're going to start understanding the causes of it and the mechanisms underlying it. So we're making progress and that's what's really important. I think it's good news for the patients, for families, for the public at large that our research is starting to pay off.
Balintfy: He says this recent study, published in the New England Journal of Medicine, shows research is translating findings from clinical trials and basic science to benefit patients.
Kiley: I think the study is an important study from the standpoint of now we have a potentially new agent that we can introduce into the toolbox, if you will, for the physician to care for patients that have chronic obstructive pulmonary disease.
Balintfy: Dr. Kiley emphasizes that while there still isnít a cure for COPD, this new treatment can make a difference.
Kiley: That's absolutely right. We hope that the physicians, public, and patients will look at these results, apply them where they are most relevant, and we can't generalize too widely here because we need to stay within the boundaries of what was done with the patients enrolled in this study. But if we do that, I think we may see some benefits in the long haul.
Balintfy: For more information on this study, and COPD, visit www.nhlbi.nih.gov. This is Joe Balintfy, National Institutes of Health, Bethesda, Maryland.
About This Audio Report
Reporter: Joe Balintfy
Sound Bite: Dr. James Kiley
Topic: chronic obstructive pulmonary disease, COPD, lung, lung disease, cough, wheezing, breath, breathing, exacerbation, flare-up, antibiotic, azithromycin
Additional Info:: Commonly prescribed antibiotic reduces acute COPD attacks