Evidence map›Paper›PMID 24779680›Full record

Trial reportAmerican journal of respiratory and critical care medicine2014

Predictors of chronic obstructive pulmonary disease exacerbation reduction in response to daily azithromycin therapy.

MeiLan K Han, Nabihah Tayob, Susan Murray, Mark T Dransfield, George Washko, Paul D Scanlon, Gerard J Criner, Richard Casaburi, John Connett, Stephen C Lazarus and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of respiratory and critical care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00325897 (Effect of Chronic Macrolide Administration on the Frequency and Severity of COPD Exacerbations), which is not on this map. Cited by 71 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 8 pooled it
15.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00325897 nacompletednot on this map

Effect of Chronic Macrolide Administration on the Frequency and Severity of COPD Exacerbations

TypeinterventionalSponsorUniversity of MinnesotaRan2006 to 2010Enrolled1,142ConditionsPulmonary Disease, Chronic ObstructiveArmsMacrolide Antibiotic (Azithromycin), Placebo
3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 8 syntheses or guidelines pooled it, 190 citations in OpenAlex.

  1. Pooled it
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  4. Effects of long-term macrolide therapy at low doses in stable COPD.International journal of chronic obstructive pulmonary disease · 2019
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  6. Guideline
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11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 9 institutions in 1 country.

MeiLan K Han1 University of Michigan Health System, Ann Arbor, Michigan.
Nabihah Tayob
Susan Murray
Mark T Dransfield
George Washko
Paul D Scanlon
Gerard J Criner
Richard Casaburi
John Connett
Stephen C Lazarus
Richard Albert
Prescott Woodruff
Fernando J Martinez
Michigan Medicine · USUniversity of California, San Francisco · USBrigham and Women's Hospital · USDenver Health Medical Center · USMayo Clinic · USTemple University · USThe Lundquist Institute · USUniversity of Alabama at Birmingham · USUniversity of Minnesota System · US

Funding

COPD Clinical Research Network - Data Coordinating CenterU10HL074424 · NHLBI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI CONNETT, JOHN E · 2003 to 2011
$21.0M
Novel Strategies Targeting Acute Exacerbation of COPDU10HL074409 · NHLBI · DENVER HEALTH AND HOSPITAL AUTHORITY · PI ALBERT, RICHARD K · 2003 to 2007
$4.1M
COPD Exacerbations: Pharmacogenetic Approaches to TherapyU10HL074428 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI WASHKO, GEORGE R · 2003 to 2007
$3.4M
UAB/BVAMC Clinical Center in COPDU10HL074418 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI DRANSFIELD, MARK T · 2003 to 2007
$3.3M
Strategies to Improve COPD ManagementU10HL074407 · NHLBI · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI CASABURI, RICHARD · 2003 to 2007
$3.2M
COPD Clinical Research Network & Clinical Research Skills Core DevelopmentU10HL074408 · NHLBI · TEMPLE UNIV OF THE COMMONWEALTH · PI CRINER, GERARD J · 2004 to 2007
$2.7M
Drug therapy for preventing COPD exacerbationsU10HL074416 · NHLBI · MINNESOTA VETERANS RESEARCH INST · PI NIEWOEHNER, DENNIS E. · 2003 to 2007
$2.7M
Clinical Center-COPD Clinical Research NetworkU10HL074441 · NHLBI · UNIVERSITY OF MARYLAND BALTIMORE · PI SCHARF, STEVEN M · 2003 to 2006
$2.6M
COPD Clinical Research NetworkU10HL074431 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LAZARUS, STEPHEN C · 2003 to 2006
$2.2M
Strategies to Prevent COPD ExacerbationU10HL074422 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARTINEZ, FERNANDO J · 2004 to 2007
$2.0M
COPD Clinical Research NetworkU10HL074439 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SCIURBA, FRANK · 2004 to 2007
$1.7M
PHARMACOGENOMICS OF INHALED CORTICOSTEROIDS TO REDUCE COPD EXACERBATIONSR01NR013377 · NINR · BRIGHAM AND WOMEN'S HOSPITAL · PI HERSH, CRAIG P · 2011 to 2013
$1.5M
NHLBI NIH HHS U10 HL074407NHLBI NIH HHS U10 HL074408NHLBI NIH HHS U10 HL074409NHLBI NIH HHS U10 HL074416NHLBI NIH HHS U10 HL074418NHLBI NIH HHS U10 HL074422NHLBI NIH HHS U10 HL074424NHLBI NIH HHS U10HL074424NHLBI NIH HHS U10 HL074428NHLBI NIH HHS U10 HL074431NHLBI NIH HHS U10 HL074439NHLBI NIH HHS U10 HL074441NINR NIH HHS R01 NR013377
6 · The paper itself

Abstract

rationaleDaily azithromycin decreases acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but long-term side effects are unknown.

objectivesTo identify the types of exacerbations most likely to be reduced and clinical subgroups most likely to benefit from azithromycin, 250 mg daily, added to usual care.

methodsEnrollment criteria included irreversible airflow limitation and AECOPD requiring corticosteroids, emergency department visit, or hospitalization in the prior year or use of supplemental oxygen. Recurrent events and cumulative incidence analyses compared treatment received for AECOPD by randomization group, stratified by subgroups of interest. Cox proportional hazards models estimated treatment effects in subgroups adjusted for age, sex, smoking status, FEV1% predicted, concomitant COPD medications, and oxygen use. MEASUREMENTS AND MAIN

resultsAzithromycin was most effective in reducing AECOPD requiring both antibiotic and steroid treatment (n = 1,113; cumulative incidence analysis, P = 0.0002; recurrent events analysis, P = 0.002). No difference in treatment response by sex (P = 0.75), presence of chronic bronchitis (P = 0.19), concomitant inhaled therapy (P = 0.29), or supplemental oxygen use (P = 0.23) was observed. Older age and milder Global Initiative for Chronic Obstructive Lung Disease stage were associated with better treatment response (P = 0.02 and 0.04, respectively). A significant interaction between treatment and current smoking was seen (P = 0.03) and azithromycin did not reduce exacerbations in current smokers (hazard ratio, 0.99; 95% confidence interval, 0.71-1.38; P = 0.95).

conclusionsAzithromycin is most effective in preventing AECOPD requiring both antibiotic and steroid treatment. Adjusting for confounders, we saw no difference in efficacy by sex, history of chronic bronchitis, oxygen use, or concomitant COPD therapy. Greater efficacy was seen in older patients and milder Global Initiative for Chronic Obstructive Lung Disease stages. We found little evidence of treatment effect among current smokers. Clinical trial registered with www.clinicaltrials.gov (NCT0011986 and NCT00325897).

Indexed as

Disease ProgressionAdrenal Cortex HormonesAgedAnti-Bacterial AgentsAnti-Inflammatory AgentsAzithromycinDrug Administration ScheduleDrug Therapy, CombinationFemaleHumansMaleMiddle AgedProportional Hazards ModelsPulmonary Disease, Chronic ObstructiveTreatment OutcomeAdrenal Cortex HormonesAnti-Bacterial AgentsAnti-Inflammatory AgentsAzithromycinazithromycinchronic obstructive pulmonary diseaseexacerbationquality of life

Identifiers

PMID24779680
PMCPMC4226018
OpenAlexW2112215977

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.