Novel approach to acute COPD illness

"This important study adds to a growing number of approaches that reduce the frequency of COPD illnesses," said Dr. Casaburi. "Together, they promise COPD patients who avail themselves of readily-available therapies substantially reduced risk of acute lung illnesses. This has the potential to reduce the misery this disease brings and can also can bring down medical costs, as more than half of COPD costs are related to hospitalization for COPD-related illnesses."

COPD is a progressive disease of the lungs that affects about 24 million people in the United States and is now the third leading cause of death in this country. Many patients experience acute COPD-related illnesses ("exacerbations"), which are sudden onsets of worsened cough, wheeze, and labored breathing that are typically induced by bacterial and/or viral infection. Previous research had suggested that the antibiotic azithromycin might decrease COPD exacerbations, but this study was the first to enroll a large number of COPD patients and treat exacerbations with this drug over a full year. Participants had a history of exacerbations in the previous year or needed oxygen therapy.

At 10 regional centers around the United States, the study recruited 558 study participants who took 250 mg of azithromycin daily for a year, in addition to their usual care. They averaged 1.48 acute COPD exacerbations annually, compared to 1.83 exacerbations for the 559 participants who received traditional care without azithromycin. The participants taking azithromycin also tended to report more favorable breathing ability and overall well-being.

Dr. Casaburi leads the Rehabilitation Clinical Trials Center, where over 50 research studies have been performed aimed at improving the lives of patients with COPD. While there is currently no cure, a combination of drugs and lifestyle changes can help manage COPD symptoms.

The results of the study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, appeared in the Aug. 25 issue of the New England Journal of Medicine. This study was conducted by the COPD Clinical Research Network (CCRN), an NHLBI-funded consortium of research centers located throughout the U.S. that was established to study new treatments for COPD.