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Randomized Controlled Trial
. 2024 Sep;23(5):870-873.
doi: 10.1016/j.jcf.2024.04.001. Epub 2024 Apr 6.

Azithromycin reduces bronchial wall thickening in infants with cystic fibrosis

Yuxin Chen  1 , Jean-Paul Charbonnier  2 , Eleni-Rosalina Andrinopoulou  3 , Peter D Sly  4 , Stephen M Stick  5 , Harm A W M Tiddens  6 ; COMBAT-CF Study Group
Affiliations
Free article
Randomized Controlled Trial

Azithromycin reduces bronchial wall thickening in infants with cystic fibrosis

Yuxin Chen et al. J Cyst Fibros. 2024 Sep.
Free article

Abstract

Background: COMBAT-CF showed that children aged 0-3 years treated with azithromycin did clinically better than placebo but there was no effect on CT-scores. We reanalysed CTs using an automatic bronchus-artery (BA) analysis.

Method: Inspiratory and expiratory CTs at 12 and 36 months were analysed. BA-analysis measures BA-diameters: bronchial outer wall (Bout), bronchial inner wall (Bin), artery (A), and bronchial wall thickness (Bwt) and computes BA-ratios: Bout/A and Bin/A for bronchial widening, Bwt/A and Bwa/Boa (bronchial wall area/bronchial outer area) for bronchial wall thickening. Low attenuation regions (LAR) were analysed using an automatic method. Mixed-effect model was used to compare BA-outcomes at 36 months between treatment groups.

Results: 228 CTs (59 placebo; 66 azithromycin) were analysed. The azithromycin group had lower Bwa/Boa (p = 0.0034) and higher Bin/A (p = 0.001) relative to placebo. Bout/A (p = 0.0088) was higher because of a reduction in artery diameters which correlated to a reduction in LAR.

Conclusion: Azithromycin-treated infants with CF show a reduction in bronchial wall thickness and possibly a positive effect on lung perfusion.

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Conflict of interest statement

Declaration of competing interest HAWMT reports grants from the Cystic Fibrosis Foundation, has a part time position as chief medical officer for Thirona, and Erasmus MC is expected to receive future license royalties for PRAGMA-CF. JPC is employee and shareholder at Thirona. SMS reports grants from the Cystic Fibrosis Foundation and National Health and Medical Research Foundation, and Telethon Kids Institute is expected to receive future license royalties for PRAGMA-CF. All other authors declare no competing interests.

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