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Cited by 600Cystic Fibrosis Research AdvancesChronic Obstructive Pulmonary Disease (COPD) ResearchMycobacterium research and diagnosis

The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.

Azithromycin for prevention of exacerbations in non-cystic fibrosis bronchiectasis (EMBRACE): a randomised, double-blind, placebo-controlled trial

Wong, Conroy, Jayaram, Lata, Karalus, Noel, Eaton, Tam, Tong, Cecilia, Hockey, Hans, Milne, David, Fergusson, Wendy, Tuffery, Christine, Sexton, Paul, Storey, Louanne, Ashton, Toni·2012·The Lancet
DOI 10.1016/s0140-6736(12)60953-2
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Abstract

Background Azithromycin is a macrolide antibiotic with anti-inflammatory and immunomodulatory properties. We tested the hypothesis that azithromycin would decrease the frequency of exacerbations, increase lung function, and improve health-related quality of life in patients with non-cystic fibrosis bronchiectasis.Methods We undertook a randomised, double-blind, placebo-controlled trial at three centres in New Zealand. Between Feb 12, 2008, and Oct 15, 2009, we enrolled patients who were 18 years or older, had had at least one pulmonary exacerbation requiring antibiotic treatment in the past year, and had a diagnosis of bronchiectasis defined by high-resolution CT scan. We randomly assigned patients to receive 500 mg azithromycin or placebo three times a week for 6 months in a 1:1 ratio, with a permuted block size of six and sequential assignment stratified by centre. Participants, research assistants, and investigators were masked to treatment allocation. The coprimary endpoints were rate of event-based exacerbations in the 6-month treatment period, change in forced expiratory volume in 1 s (FEV(1)) before bronchodilation, and change in total score on St George's respiratory questionnaire (SGRQ). Analyses were by intention to treat. This study is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12607000641493.Findings 71 patients were in the azithromycin group and 70 in the placebo group. The rate of event-based exacerbations was 0·59 per patient in the azithromycin group and 1·57 per patient in the placebo group in the 6-month treatment period (rate ratio 0·38, 95% CI 0·26-0·54; p<0·0001). Prebronchodilator FEV(1) did not change from baseline in the azithromycin group and decreased by 0·04 L in the placebo group, but the difference was not significant (0·04 L, 95% CI -0·03 to 0·12; p=0·251). Additionally, change in SGRQ total score did not differ between the azithromycin (-5·17 units) and placebo groups (-1·92 units; difference -3·25, 95% CI -7·21 to 0·72; p=0·108).Interpretation Azithromycin is a new option for prevention of exacerbations in patients with non-cystic fibrosis bronchiectasis with a history of at least one exacerbation in the past year.Funding Health Research Council of New Zealand and Auckland District Health Board Charitable Trust.

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Metadata

Authors
Wong, C., Jayaram, L., Karalus, N., Eaton, T., Tong, C., Hockey, H., Milne, D., Fergusson, W., Tuffery, C., Sexton, P., Storey, L., & Ashton, T.
Affiliations
  • Middlemore Hospital (NZ)
  • Monash Medical Centre (AU)
  • Waikato Hospital (NZ)
  • Auckland City Hospital (NZ)
  • University of Auckland (NZ)
Corresponding author
Wong, Conroy
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2012-08
Volume
380
Issue
9842
Pages
660-667
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(12)60953-2
OpenAlex
W2169216429
Cited by
600
References
38
Citations by year
2026: 33 · 2025: 22 · 2024: 29 · 2023: 21 · 2022: 33 · 2021: 36 · 2020: 37 · 2019: 48 · 2018: 56 · 2017: 59 · 2016: 45 · 2015: 52 · 2014: 67 · 2013: 55 · 2012: 6
FWCI
46.39
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Epidemiology › Mycobacterium research and diagnosis
Keywords
azithromycin, non-cystic fibrosis bronchiectasis, pulmonary exacerbations, macrolide antibiotics, anti-inflammatory therapy, lung function, health-related quality of life, St George's Respiratory Questionnaire, FEV1, EMBRACE trial, antibiotic prophylaxis, immunomodulation, adverse events
MeSH terms
Adult, Aged, Anti-Bacterial Agents, Bronchiectasis, Cystic Fibrosis, Double-Blind Method, Drug Administration Schedule, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Quality of Life, Vital Capacity, Treatment Outcome, Azithromycin, Secondary Prevention

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