Lavoie Gabriel, Howell Imran, Melhorn James, Borg Catherine, Bermejo-Sanchez Laura, Seymour Jack, Jabeen Maisha F, Fries Anastasia, Hynes Gareth, Pavord Ian D, Petousi Nayia, Hinks Timothy Sc
Respiratory Medicine Unit and NIHR Oxford Biomedical Research Centre, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Respiratory Medicine Unit and NIHR Oxford Biomedical Research Centre, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
Thorax. 2025 Jan 17;80(2):113-116. doi: 10.1136/thorax-2024-221977.
Macrolides reduce exacerbations when added to inhaled therapy in severe asthma. However, there is little published evidence for effectiveness in patients treated with biologics. We conducted a retrospective audit of all patients who started azithromycin while on biologics in our centre. Compared with those that did not start azithromycin, these individuals had more exacerbations and a phenotype of chronic bronchitis and/or frequent purulent exacerbations. The addition of azithromycin to biologics was associated with reduced annual rates of steroid-treated and antibiotic-treated exacerbations and improved symptom scores (Asthma Control Questionnaire-5) but not with any improvement in lung function. Data support testing azithromycin in clinical trials in patients on biologics with residual exacerbations.
在重度哮喘患者中，大环内酯类药物添加到吸入治疗中可减少病情加重。然而，关于其在接受生物制剂治疗的患者中的有效性，鲜有公开证据。我们对本中心所有在接受生物制剂治疗时开始使用阿奇霉素的患者进行了一项回顾性审计。与未开始使用阿奇霉素的患者相比，这些患者病情加重的情况更多，且具有慢性支气管炎和/或频繁脓性加重的表型。在生物制剂治疗中添加阿奇霉素与类固醇治疗和抗生素治疗的病情加重年发生率降低以及症状评分（哮喘控制问卷-5）改善相关，但对肺功能没有任何改善。数据支持在有残余病情加重的接受生物制剂治疗的患者中进行阿奇霉素的临床试验。
