Prophylactic Azithromycin Therapy After Lung Transplantation: Post hoc Analysis of a Randomized Controlled Trial. Issue 1 (4th August 2015)

• Record Type: Journal Article
• Authors: Ruttens, D.; Verleden, S. E.; Vandermeulen, E.; Bellon, H.; Vanaudenaerde, B. M.; Somers, J.; Schoonis, A.; Schaevers, V.; Van Raemdonck, D. E.; Neyrinck, A.; Dupont, L. J.; Yserbyt, J.; Verleden, G. M.; Vos, R.
• Is Part Of: American journal of transplantation. Volume 16:Issue 1(2016:Jan.)
• Page Start: 254
• Page End: 261
• Publication Date: 2015-08-04
• Subjects: (allograft) function/dysfunction -- bronchiolitis obliterans (BOS) -- clinical research/practice -- lung failure/injury -- lung -- lung transplantation/pulmonology -- preventive healthcare -- rejection: chronic; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.13417
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Prophylactic azithromycin treatment has been demonstrated to improve freedom from bronchiolitis obliterans syndrome (BOS) 2 years after lung transplantation (LTx). In the current study, we re‐evaluated the long‐term effects of this prophylactic approach in view of the updated classification system for chronic lung allograft dysfunction (CLAD). A retrospective, intention‐to‐treat analysis of a randomized controlled trial comparing prophylactic treatment with placebo (n = 43) versus azithromycin (n = 40) after LTx was performed. Graft dysfunction (CLAD), graft loss (retransplantation, mortality), evolution of pulmonary function and functional exercise capacity were analyzed 7 years after inclusion of the last study subject. Following LTx, 22/43 (51%) patients of the placebo group and 11/40 (28%) patients of the azithromycin group ever developed CLAD (p = 0.043). CLAD‐free survival was significantly longer in the azithromycin group (p = 0.024). No difference was present in proportion of obstructive versus restrictive CLAD between both groups. Graft loss was similar in both groups: 23/43 (53%) versus 16/40 (40%) patients (p = 0.27). Long‐term pulmonary function and functional exercise capacity were significantly better in the azithromycin group (p < 0.05). Prophylactic azithromycin therapy reduces long‐term CLAD prevalence and improves CLAD‐free survival, pulmonary function, and functional exercise capacity after LTx. Abstract : This post hoc analysis of a randomized controlled trial demonstrates improved chronic lung allograft dysfunction‐free survival, pulmonary function, and exercise capacity with prophylactic azithromycin therapy after lung transplantation.