Simon D. Fraser
Azithromycin for sarcoidosis cough: an open label exploratory clinical trial
Fraser, Simon D.; Thackray-Nocera, Susannah; Shepherd, Marica; Flockton, Rachel; Wright, Caroline; Sheedy, Wayne; Brindle, Kayleigh; Morice, Alyn H.; Kaye, Paul M.; Crooks, Michael G.; Hart, Simon P.
Mr Wayne Sheedy W.Sheedy@hull.ac.uk
Research Group Manager
Professor Alyn Morice A.H.Morice@hull.ac.uk
Foundation Chair and Professor of Respiratory Medicine
Paul M. Kaye
Dr Michael Crooks firstname.lastname@example.org
Senior Clinical Lecturer in Respiratory Medicine
Dr Simon Hart S.Hart@hull.ac.uk
Reader in Respiratory Medicine
Background Chronic cough is a distressing symptom for many people with pulmonary sarcoidosis. Continuous treatment with a macrolide antibiotic may improve cough. We aimed to assess the potential efficacy of azithromycin in patients with sarcoidosis and self-reported cough.
Methods We did a non-controlled, open label clinical trial of azithromycin 250 mg once daily for 3 months in patients with pulmonary sarcoidosis who reported a chronic cough. The primary outcome was number of coughs in 24 h. Secondary outcomes were cough visual analog scales and quality of life measured using the Leicester Cough Questionnaire and King's Sarcoidosis Questionnaire. Safety outcomes included QTc interval on ECG. Measurements were made at baseline and after one and 3 months of treatment.
Results All 21 patients were white, median age 57 years, 9 males/12 females, median 3 years since diagnosis. Five were taking oral corticosteroids and none were taking other immunosuppressants. Twenty patients completed the trial. The median (range) number of coughs in 24 h was 228 (43–1950) at baseline, 122 (20–704) at 1 month, and 81 (16–414) at 3 months (p=0.002, Friedman's test). The median reduction in cough count at 3 months was 49.6%. There were improvements in all patient-reported outcomes. Azithromycin was well tolerated.
Conclusion In a non-controlled open-label trial in people with sarcoidosis who reported a chronic cough, 3 months of treatment with azithromycin led to improvements in a range of cough metrics. Azithromycin should be tested as a treatment for sarcoidosis cough in a randomised placebo-controlled trial.
Fraser, S. D., Thackray-Nocera, S., Shepherd, M., Flockton, R., Wright, C., Sheedy, W., …Hart, S. P. (2020). Azithromycin for sarcoidosis cough: an open label exploratory clinical trial. ERJ Open Research, 6(4), https://doi.org/10.1183/23120541.00534-2020
|Journal Article Type||Article|
|Acceptance Date||Sep 9, 2020|
|Online Publication Date||Nov 10, 2020|
|Publication Date||Oct 1, 2020|
|Deposit Date||Oct 17, 2020|
|Publicly Available Date||Oct 19, 2020|
|Journal||ERJ Open Research|
|Publisher||European Respiratory Society|
|Peer Reviewed||Peer Reviewed|
Publisher Licence URL
Copyright ©ERS 2020. http://creativecommons.org/licenses/by-nc/4.0/
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
Publisher Licence URL
Copyright ©ERS 2020. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
You might also like
Characterisation of a New Human Alveolar Macrophage-Like Cell Line (Daisy)
The Leicester Cough Monitor: a semi-automated, semi-validated cough detection system? Reply
The online Cough Clinic: Developing guideline-based diagnosis and advice