Journal
LANCET RESPIRATORY MEDICINE
Volume 2, Issue 8, Pages 657-670Publisher
ELSEVIER SCI LTD
DOI: 10.1016/S2213-2600(14)70107-9
Keywords
-
Categories
Funding
- ERC [233015]
- Clinical Chair from Asthma UK [CH11SJ]
- MRC Centre [G1000758]
- Predicta FP7 Collaborative Project [260895]
- Wellcome Trust sponsored Centre for Respiratory Infection
- Asthma UK [RF07/04]
- BBSRC CASE studentship in association with Pfizer
- Asthma UK [RF07/04, MRC-AsthmaUKCentre, MRC-Asthma UK Centre] Funding Source: researchfish
- Medical Research Council [G1000758B, G1000758] Funding Source: researchfish
- MRC [G0601236, G0600879] Funding Source: UKRI
Ask authors/readers for more resources
Macrolides, such as darithromycin and azithromycin, possess antimicrobial, immunomodulatory, and potential antiviral properties. They represent a potential therapeutic option for asthma, a chronic inflammatory disorder characterised by airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. Results from clinical trials, however, have been contentious. The findings could be confounded by many factors, induding the heterogeneity of asthma, treatment duration, dose, and differing outcome measures. Recent evidence suggests improved effectiveness of macrolides in patients with sub-optimally controlled severe neutrophilic asthma and in asthma exacerbations. We examine the evidence from dinical trials and discuss macrolide properties and their relevance to the pathophysiology of asthma. At present, the use of macrolides in chronic asthma or acute exacerbations is not justified. Further work, including proteomic, genomic, and microbiome studies, will advance our knowledge of asthma phenotypes, and help to identify a macrolide-responsive subgroup. Future dinical trials should target this subgroup and place emphasis on clinically relevant outcomes such as asthma exacerbations.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available