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Cited by 288Asthma and respiratory diseasesChronic Obstructive Pulmonary Disease (COPD) ResearchPneumonia and Respiratory Infections

The Effect of Telithromycin in Acute Exacerbations of Asthma

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Johnston, Sebastian L., Blasi, Francesco, Black, Peter N., Martin, Richard J., Farrell, David J., Nieman, Richard B.·2006·New England Journal of Medicine
DOI 10.1056/nejmoa044080
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Abstract

BACKGROUND: We conducted a double-blind, randomized, placebo-controlled study to evaluate the efficacy of telithromycin in patients with acute exacerbations of asthma. METHODS: A total of 278 adults with diagnosed asthma were enrolled within 24 hours after an acute exacerbation of asthma requiring short-term medical care. The patients were randomly assigned to receive 10 days of oral treatment with telithromycin (at a dose of 800 mg daily) or placebo in addition to usual care. Primary efficacy end points were a change from baseline over the treatment period in symptoms (as recorded by patients in a diary card) and in the peak expiratory flow in the morning at home. The presence of Chlamydophila pneumoniae or Mycoplasma pneumoniae was ascertained by serologic analysis, polymerase chain reaction, and culture. RESULTS: Of the two prespecified primary outcomes, only asthma symptoms showed a significantly greater reduction among patients receiving telithromycin than among those receiving placebo. Mean (+/-SD) scores on a test of asthma symptoms (on a 7-point scale, with 0 denoting no symptoms and 6 denoting severe symptoms) were 3.0+/-1.4 at baseline and 1.7+/-1.1 at the end of treatment for the telithromycin group and 2.8+/-1.3 at baseline and 2.0+/-1.0 at the end of treatment for the placebo group. The mean decrease in symptom scores during the treatment period was 1.3 for telithromycin and 1.0 for placebo (mean difference, -0.3; 95 percent confidence interval, -0.5 to -0.1; P=0.004). There was no significant treatment effect on the other primary outcome measure, a change in morning peak expiratory flow. Nausea was more common among patients in the telithromycin group than in the placebo group (P=0.01). Although 61 percent of patients had evidence of infection with C. pneumoniae, M. pneumoniae, or both, there was no relationship between bacteriologic status and the response to asthma treatment. CONCLUSIONS: This study provides evidence of the benefit of telithromycin in patients with acute exacerbations of asthma; the mechanisms of benefit remain unclear. (ClinicalTrials.gov number, NCT00273520.).

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  • Early studies demonstrated increased susceptibility of mammalian cells to bacterial adherence as a result of viral infection in vitro and in vivo.

    “Early studies demonstrated increased susceptibility of mammalian cells to bacterial adherence as a result of viral infection in vitro (60, 251) and in vivo (131, 204, 213, 215, 250).”

    From The airway epithelium: soldier in the fight against respiratory viruses (2011) · cites this paper as [131]

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Research works printed but not linked: 4

  1. 3. ical isolates of Mycoplasma pneumoniae in Japan. Antimicrob Agents Chemother 2000; 44:1381-2.
  2. The New England Journal of Medicine Downloaded from nejm.org on August 30, 2023. For personal use only. No other uses without permission. Copyright © 2006 Massachusetts Medical Society. All rights reserved. n engl j med 354;15
  3. moniae in asthma: effect of clarithromy- cin. Chest 2002;121:1782-8.
  4. Biscione GL, Corne J, Chauhan AJ, Johnston SL. Increased frequency of detec- tion of Chlamydophila pneumoniae in asthma. Eur Respir J 2004;24:745-9.

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Authors
Johnston, S. L., Blasi, F., Black, P. N., Martin, R. J., Farrell, D. J., & Nieman, R. B.
Affiliations
  • Imperial College London (GB)
  • University of Milan (IT)
  • University of Auckland (NZ)
  • National Jewish Health (US)
  • Sanofi (United States) (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2006-04-13
Volume
354
Issue
15
Pages
1589-1600
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa044080
OpenAlex
W1974143308
Cited by
288
References
23
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 8 · 2021: 4 · 2020: 6 · 2019: 6 · 2018: 8 · 2017: 14 · 2016: 19 · 2015: 16 · 2014: 15 · 2013: 10 · 2012: 17
FWCI
21.96
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Pfizer
  • GlaxoSmithKline
  • Sanofi
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Keywords
telithromycin, macrolide antibiotics, asthma symptoms, peak expiratory flow, Chlamydia pneumoniae, Mycoplasma pneumoniae, respiratory infections, nausea
MeSH terms
Acute Disease, Administration, Oral, Adolescent, Adrenal Cortex Hormones, Adult, Aged, Anti-Bacterial Agents, Asthma, Double-Blind Method, Drug Therapy, Combination, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Mycoplasma pneumoniae, Peak Expiratory Flow Rate, Pneumonia, Mycoplasma, Treatment Outcome, Chlamydophila pneumoniae, Chlamydophila Infections, Ketolides

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