User login

Enter your username and password here in order to log in on the website:
Login

Forgot your password?

Please note: While some information will still be current in a year, other information may already be out of date in three months time. If you are in any doubt, please feel free to ask.

Azithromycin

Question
Hello,

I am 37 years old and have CF. I am currently taking azithromycin again. Are there any long-term studies on the effects of this drug? Improvements in lung function, etc.?

Many thanks.
Answer
Dear questioner,

Many thanks for this important question on the effects of taking azithromycin as long-term therapy. It is indeed right that the published double blind, randomized studies, which have shown a positive effect on lung function (improvement of forced expiratory volume in one second, FEV1, by less than 5%) and a reduction of infection rate, were conducted over a period of 6 months (in adults) and 12 months (in children and adolescents). Long-term data on the benefit of azithromycin has been missing until recently.

The group around M. Hodson (actually a pioneer of CF treatment) at Royal Bromton Hospital has published a so-called retrospective study involving 81 adults affected by CF in the current online version of the Journal of Cystic Fibrosis (J Cyst Fibros. 2012 Jul 14. [Epub ahead of print]). Like the placebo-controlled studies, this group found a slight improvement after one year of therapy as well; however, it was shown that the FEV1 dropped again in the second year, to levels similar to those in the year before therapy with azithromycin began. In other words, azithromycin therapy only seems to lead to a temporary improvement in lung function; unfortunately, the FEV1 drops again after a certain time (probably one year), to a level comparable to that before therapy. In addition, the group was not able to show a positive influence on the infection rate.

Well, this study is a so-called retrospective study and we can not say whether these patients would not possibly have had a worse FEV1 if they had not been treated with azithromycin. Unfortunately, this phenomenon of the therapeutic outcome wearing off after a certain time is well known in medicine and true for many chronic diseases that are treated with one drug long-term. Concerning azithromycin, it is certainly too early now to give a general recommendation on the duration of therapy. It remains to be hoped that there will be funds for a long-term placebo-controlled study which looks at the effect of azithromycin.

Kind regards,
Dr. Markus Hofer
Adult CF Clinic
Zurich University Hospital
02.08.2012