Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/11102
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dc.contributor.authorRobin, Vos-
dc.contributor.authorVanaudenaerde, BM-
dc.contributor.authorOttevaere, A-
dc.contributor.authorVerleden, SE-
dc.contributor.authorDe Vleeschauwer, SI-
dc.contributor.authorWIDYASTUTI, Anna-
dc.contributor.authorWAUTERS, Shana-
dc.contributor.authorVan Raemdonck, DE-
dc.contributor.authorNAWROT, Tim-
dc.contributor.authorDupont LJ-
dc.contributor.authorVerleden GM-
dc.date.accessioned2010-08-10T11:55:33Z-
dc.date.availableNO_RESTRICTION-
dc.date.issued2010-
dc.identifier.citationJOURNAL OF HEART AND LUNG TRANSPLANTATION, 29(12). p. 1358-1368-
dc.identifier.issn1053-2498-
dc.identifier.urihttp://hdl.handle.net/1942/11102-
dc.description.abstractBACKGROUND: Azithromycin may reverse or halt the decline of pulmonary function (FEV(1)) in bronchiolitis obliterans syndrome (BOS). In this study we investigated the effects of long-term azithromycin treatment in lung transplant recipients with BOS. METHODS: A retrospective, observational, cohort study was performed on 107 patients with BOS (Stages 0p/1/2/3, n = 23/62/20/2), who were treated with azithromycin for 3.1 +/- 1.9 years. Patients were evaluated 6.3 +/- 3.8 years after transplantation and assessed for evolution of FEV(1), bronchoalveolar lavage neutrophilia and overall survival after initiation of azithromycin. Survival curves were analyzed using the log-rank test. Cox proportional hazard survival regression analysis was performed to estimate hazard ratios of clinical variables predicting outcome. RESULTS: FEV(1) increased >/=10% after 3 to 6 months of treatment in 40% of patients, of whom 33% later redeveloped BOS. FEV(1) further declined in 78% and stabilized in 22% of the remaining non-responders. Pre-treatment neutrophilia was higher in responders: 29.3% (9.3% to 69.7%) vs 11.5% (2.9% to 43.8%) (p = 0.025), in whom it significantly decreased to 4.2% (1.8% to 17.6%) (p = 0.041) after 3 to 6 months of azithromycin. Responders demonstrated better survival compared with non-responders (p = 0.050), with 6 and 21 patients, respectively, dying during follow-up (p = 0.027). Multivariate analysis identified initial azithromycin response and earlier post-transplant initiation of azithromycin to be protective for both BOS progression/relapse (hazard ratio [HR] = 0.12 [95% confidence interval 0.05 to 0.28], p < 0.0001; and HR = 0.98 [95% confidence interval 0.97 to 0.98], p < 0.0001, respectively) and retransplantation/death during follow-up (HR 0.10 [95% confidence interval 0.02 to 0.48], p = 0.004; and HR 0.96 [95% confidence interval 0.95 to 0.98], p < 0.0001, respectively). CONCLUSIONS: Long-term azithromycin benefits pulmonary function and survival in BOS, particularly in patients with increased lavage neutrophilia.-
dc.description.sponsorshipThe first three authors (R V, BMV, AO) contributed equally to this study This investigation was supported by the Research Foundation-Flanders (FWO G 0518 06, G 0643 08, and OT10/050) We thank the following individuals for their support C Jans, C Rosseel and M Meelberghs (Lung Transplant Unit Outpatient Clinic), Dr A Van Den Eeckhout, Prof Dr C Dooms, J Foulon and F Vandeweyer (Department of Bronchoscopy), F Rochette and Y Dewandeleer (Department of Pulmonary Function), and D Van Raemdonck, W Coosemans, H Decaluwe, P De Leyn, P Nafteux and T Lerut (Department of Thoracic Surgery)-
dc.languageENG-
dc.language.isoen-
dc.publisherElsevier Science-
dc.rights2010 International Society for Heart and Lung Transplantation All rights reserved-
dc.subject.otherazithromycin-
dc.subject.otherbronchiolitis obliterans-
dc.subject.othersyndrome-
dc.subject.otherchronic allograft rejection-
dc.subject.otherpulmonary function survival-
dc.subject.othersurvival-
dc.titleLong-term azithromycin therapy for bronchiolitis obliterans syndrome: Divide and conquer?-
dc.typeJournal Contribution-
dc.identifier.epage1368-
dc.identifier.issue12-
dc.identifier.spage1358-
dc.identifier.volume29-
local.bibliographicCitation.jcatA1-
dc.description.notesLaboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium.-
dc.relation.pmid20619683-
local.publisher.place360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA-
local.type.refereedRefereed-
local.type.specifiedArticle-
dc.bibliographicCitation.oldjcatA1-
dc.source.typeArticle-
dc.identifier.doi10.1016/j.healun.2010.05.023-
dc.identifier.pmid20619683-
dc.identifier.isi000285220700006-
dc.identifier.eissn1557-3117-
local.provider.typePubMed-
local.uhasselt.uhpubyes-
item.fulltextNo Fulltext-
item.accessRightsClosed Access-
item.contributorVerleden GM-
item.contributorRobin, Vos-
item.contributorWIDYASTUTI, Anna-
item.contributorVan Raemdonck, DE-
item.contributorDe Vleeschauwer, SI-
item.contributorVanaudenaerde, BM-
item.contributorWAUTERS, Shana-
item.contributorDupont LJ-
item.contributorOttevaere, A-
item.contributorVerleden, SE-
item.contributorNAWROT, Tim-
item.fullcitationRobin, Vos; Vanaudenaerde, BM; Ottevaere, A; Verleden, SE; De Vleeschauwer, SI; WIDYASTUTI, Anna; WAUTERS, Shana; Van Raemdonck, DE; NAWROT, Tim; Dupont LJ & Verleden GM (2010) Long-term azithromycin therapy for bronchiolitis obliterans syndrome: Divide and conquer?. In: JOURNAL OF HEART AND LUNG TRANSPLANTATION, 29(12). p. 1358-1368.-
item.validationecoom 2012-
crisitem.journal.issn1053-2498-
crisitem.journal.eissn1557-3117-
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