Secondary outcomes of a pilot randomized trial of azithromycin treatment for asthma

Submitted by Jim K on Sun, 2006-07-30 00:11

 PLoS Clin Trials. 2006 Jun;1(2):e11. Epub 2006 Jun 30.  Secondary outcomes of a pilot randomized trial of azithromycin treatment for asthma.Hahn DL, Plane MB, Mahdi OS, Byrne GI.Dean Medical Center, East Clinic, Madison, Wisconsin, United States of America.OBJECTIVES: The respiratory pathogen Chlamydia pneumoniae (C. pneumoniae) produces acute and chronic lung infections and is associated with asthma. Evidence for effectiveness of antichlamydial antibiotics in asthma is limited. The primary objective of this pilot study was to investigate the feasibility of performing an asthma clinical trial in practice settings where most asthma is encountered and managed. The secondary objectives were to investigate (1) whether azithromycin treatment would affect any asthma outcomes and (2) whether C. pneumoniae serology would be related to outcomes. This report presents the secondary results. DESIGN: Randomized, placebo-controlled, blinded (participants, physicians, study personnel, data analysts), allocation-concealed parallel group clinical trial. SETTING: Community-based health-care settings located in four states and one Canadian province. PARTICIPANTS: Adults with stable, persistent asthma. INTERVENTIONS: Azithromycin (six weekly doses) or identical matching placebo, plus usual community care. OUTCOME MEASURES: Juniper Asthma Quality of Life Questionnaire (Juniper AQLQ), symptom, and medication changes from baseline (pretreatment) to 3 mo posttreatment (follow-up); C. pneumoniae IgG and IgA antibodies at baseline and follow-up. RESULTS: Juniper AQLQ improved by 0.25 (95% confidence interval; -0.3, 0.8) units, overall asthma symptoms improved by 0.68 (0.1, 1.3) units, and rescue inhaler use decreased by 0.59 (-0.5, 1.6) daily administrations in azithromycin-treated compared to placebo-treated participants. Baseline IgA antibodies were positively associated with worsening overall asthma symptoms at follow-up (p = 0.04), but IgG was not (p = 0.63). Overall asthma symptom improvement attributable to azithromycin was 28% in high IgA participants versus 12% in low IgA participants (p for interaction = 0.27). CONCLUSIONS: Azithromycin did not improve Juniper AQLQ but appeared to improve overall asthma symptoms. Larger community-based trials of antichlamydial antibiotics for asthma are warranted.

Diseases associated with Cpn: the exhaustive list

Submitted by Jim K on Sun, 2006-01-22 08:41

I have culled from Mitchell & Stratton patent #6,884,784 an exhaustive list of diseases where Cpn has been implicated as a possible cause or co-factor (reference: Mitchell & Stratton patent #6,884,784):

Diseases where an association has been discovered between chronic Chlamydia infection of body fluids and/or tissues with several disease syndromes of previously unknown etiology in humans which respond to unique antichlamydial regimens include:

Editorial comment: Strong findings from their research. If you have any of these it suggests to me that at least an empirical course of the combination antibiotic therapy is strongly indicated, with or without serology. Multiple Sclerosis (MS) Rheumatoid Arthritis (RA) Inflammatory Bowel Disease (IBD) Interstitial Cystitis (IC) Fibromyalgia (FM) Autonomic nervous dysfunction (AND neural-mediated hypotension); Pyoderma Gangrenosum (PG) Chronic Fatigue (CF) and Chronic Fatigue Syndrome (CFS).

Serological evidence of Chlamydia pneumoniae in asthma.

Submitted by Jim K on Wed, 2005-08-24 20:34

Serological evidence of infection with Chlamydia pneumoniae is related to the severity of asthma.

  • Chlamydia pneumoniae as an Emerging Risk Factor in Cardiovascular Disease
  • Murat V. Kalayoglu, MD, PhD; Peter Libby, MD; Gerald I. Byrne, PhD , JAMA. 2002;288:2724-2731