Evidence map›Paper›PMID 28558695›Full record

Trial reportRespiratory research2017

Azithromycin and risk of COPD exacerbations in patients with and without Helicobacter pylori.

Seung Won Ra, Marc A Sze, Eun Chong Lee, Sheena Tam, Yeni Oh, Nick Fishbane, Gerard J Criner, Prescott G Woodruff, Stephen C Lazarus, Richard Albert and 8 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Respiratory research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
0.7field-weighted citation impact, top 27% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. International journal of chronic obstructive pulmonary disease · 2026
    Pooled it
  2. Effects of long-term macrolide therapy at low doses in stable COPD.International journal of chronic obstructive pulmonary disease · 2019
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 11 institutions in 3 countries.

Seung Won RaCentre for Heart Lung Innovation, St. Paul's Hospital, & Department of Medicine (Respiratory Division), University of British Columbia, Don D Sin, Room 8446-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Marc A SzeDepartment of Microbiology & Immunology, University of Michigan, Ann Arbor, MI, USA.
Eun Chong LeeCentre for Heart Lung Innovation, St. Paul's Hospital, & Department of Medicine (Respiratory Division), University of British Columbia, Don D Sin, Room 8446-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Sheena TamCentre for Heart Lung Innovation, St. Paul's Hospital, & Department of Medicine (Respiratory Division), University of British Columbia, Don D Sin, Room 8446-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Yeni OhCentre for Heart Lung Innovation, St. Paul's Hospital, & Department of Medicine (Respiratory Division), University of British Columbia, Don D Sin, Room 8446-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Nick FishbaneCentre for Heart Lung Innovation, St. Paul's Hospital, & Department of Medicine (Respiratory Division), University of British Columbia, Don D Sin, Room 8446-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Gerard J CrinerDepartment of Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, USA.
Prescott G WoodruffDepartment of Medicine, University of California San Francisco, San Francisco, CA, USA.
Stephen C LazarusDepartment of Medicine, University of California San Francisco, San Francisco, CA, USA.
Richard AlbertPulmonary Sciences and Critical Care Medicine, University of Colorado, Denver, CO, USA.
John E ConnettSchool of Public Health, University of Minnesota, Minneapolis, MN, USA.
Meilan K HanDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Fernando J MartinezJoan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA.
Shawn D AaronDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada.
Robert M ReedDivision of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
S F Paul ManCentre for Heart Lung Innovation, St. Paul's Hospital, & Department of Medicine (Respiratory Division), University of British Columbia, Don D Sin, Room 8446-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Don D SinCentre for Heart Lung Innovation, St. Paul's Hospital, & Department of Medicine (Respiratory Division), University of British Columbia, Don D Sin, Room 8446-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. Don.Sin@hli.ubc.ca.
Canadian Respiratory Research Network
University of British Columbia · CASt. Paul's Hospital · CAUniversity of California, San Francisco · USUniversity of Michigan · USCornell University · USTemple University · USUlsan College · KRUniversity of Colorado Denver · USUniversity of Maryland, Baltimore · USUniversity of Minnesota · USUniversity of Ottawa · CA

Funding

Mentoring Research in Precision Medicine for Lung DiseaseK24HL137013 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PRESCOTT G WOODRUFF · 2017 to 2026
$1.2M
CIHRNHLBI NIH HHS K24 HL137013
6 · The paper itself

Abstract

backgroundHelicobacter pylori (HP) infection is associated with reduced lung function and systemic inflammation in chronic obstructive pulmonary disease (COPD) patients. Azithromycin (AZ) is active against HP and reduces the risk of COPD exacerbation. We determined whether HP infection status modifies the effects of AZ in COPD patients.

methodsPlasma samples from 1018 subjects with COPD who participated in the Macrolide Azithromycin (MACRO) in COPD Study were used to determine the HP infection status at baseline and 12 months of follow-up using a serologic assay. Based on HP infection status and randomization to either AZ or placebo (PL), the subjects were divided into 4 groups: HP+/AZ, HP-/AZ, HP+/PL, and HP-/PL. Time to first exacerbation was compared across the 4 groups using Kaplan-Meier survival analysis and a Cox proportional hazards model. The rates of exacerbation were compared using both the Kruskal-Wallis test and negative binomial analysis. Blood biomarkers at enrolment and at follow-up visits 3, 12, and 13 (1 month after treatment was stopped) months were measured.

resultsOne hundred eighty one (17.8%) patients were seropositive to HP. Non-Caucasian participants were nearly three times more likely to be HP seropositive than Caucasian participants (37.4% vs 13.6%; p < 0.001). The median time to first exacerbation was significantly different across the four groups (p = 0.001) with the longest time in the HP+/AZ group (11.2 months, 95% CI; 8.4-12.5+) followed by the HP-/AZ group (8.0 months, 95% CI; 6.7-9.7). Hazard ratio (HR) for exacerbations was lowest in the HP+/AZ group after adjustment for age, sex, smoking status, ethnicity, history of peptic ulcer, dyspnea, previous hospital admission, GOLD grade of severity, and forced vital capacity (HR, 0.612; 95% CI, 0.442-0.846 vs HR, 0.789; 95% CI, 0.663-0.938 in the HP-/AZ group). Circulating levels of soluble tumor necrosis factor receptor-75 were reduced only in the HP+/AZ group after 3 months of AZ treatment (-0.87 ± 0.31 μg/L; p = 0.002); levels returned to baseline after discontinuing AZ.

conclusionsAZ is effective in preventing COPD exacerbations in patients with HP seropositivity, possibly by modulating TNF pathways related to HP infection.

Indexed as

AgedAnti-Bacterial AgentsAntibodies, BacterialAzithromycinBiomarkersC-Reactive ProteinDisease-Free SurvivalDisease ProgressionFemaleHelicobacter InfectionsHelicobacter pyloriHumansKaplan-Meier EstimateLungMaleMiddle AgedAnti-Bacterial AgentsAntibodies, BacterialAzithromycinBiomarkersC-Reactive ProteinReceptors, Tumor Necrosis Factor, Type IITNFRSF1B protein, humanAzithromycinCOPDExacerbationHelicobacter pylori

Identifiers

PMID28558695
PMCPMC5450077
OpenAlexW2619857740

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.