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http://hdl.handle.net/1942/11102
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DC Field | Value | Language |
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dc.contributor.author | Robin, Vos | - |
dc.contributor.author | Vanaudenaerde, BM | - |
dc.contributor.author | Ottevaere, A | - |
dc.contributor.author | Verleden, SE | - |
dc.contributor.author | De Vleeschauwer, SI | - |
dc.contributor.author | WIDYASTUTI, Anna | - |
dc.contributor.author | WAUTERS, Shana | - |
dc.contributor.author | Van Raemdonck, DE | - |
dc.contributor.author | NAWROT, Tim | - |
dc.contributor.author | Dupont LJ | - |
dc.contributor.author | Verleden GM | - |
dc.date.accessioned | 2010-08-10T11:55:33Z | - |
dc.date.available | NO_RESTRICTION | - |
dc.date.issued | 2010 | - |
dc.identifier.citation | JOURNAL OF HEART AND LUNG TRANSPLANTATION, 29(12). p. 1358-1368 | - |
dc.identifier.issn | 1053-2498 | - |
dc.identifier.uri | http://hdl.handle.net/1942/11102 | - |
dc.description.abstract | BACKGROUND: 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.sponsorship | The 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.language | ENG | - |
dc.language.iso | en | - |
dc.publisher | Elsevier Science | - |
dc.rights | 2010 International Society for Heart and Lung Transplantation All rights reserved | - |
dc.subject.other | azithromycin | - |
dc.subject.other | bronchiolitis obliterans | - |
dc.subject.other | syndrome | - |
dc.subject.other | chronic allograft rejection | - |
dc.subject.other | pulmonary function survival | - |
dc.subject.other | survival | - |
dc.title | Long-term azithromycin therapy for bronchiolitis obliterans syndrome: Divide and conquer? | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | 1368 | - |
dc.identifier.issue | 12 | - |
dc.identifier.spage | 1358 | - |
dc.identifier.volume | 29 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium. | - |
dc.relation.pmid | 20619683 | - |
local.publisher.place | 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.bibliographicCitation.oldjcat | A1 | - |
dc.source.type | Article | - |
dc.identifier.doi | 10.1016/j.healun.2010.05.023 | - |
dc.identifier.pmid | 20619683 | - |
dc.identifier.isi | 000285220700006 | - |
dc.identifier.eissn | 1557-3117 | - |
local.provider.type | PubMed | - |
local.uhasselt.uhpub | yes | - |
item.validation | ecoom 2012 | - |
item.contributor | Robin, Vos | - |
item.contributor | Vanaudenaerde, BM | - |
item.contributor | Ottevaere, A | - |
item.contributor | Verleden, SE | - |
item.contributor | De Vleeschauwer, SI | - |
item.contributor | WIDYASTUTI, Anna | - |
item.contributor | WAUTERS, Shana | - |
item.contributor | Van Raemdonck, DE | - |
item.contributor | NAWROT, Tim | - |
item.contributor | Dupont LJ | - |
item.contributor | Verleden GM | - |
item.fulltext | No Fulltext | - |
item.accessRights | Closed Access | - |
item.fullcitation | Robin, 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. | - |
crisitem.journal.issn | 1053-2498 | - |
crisitem.journal.eissn | 1557-3117 | - |
Appears in Collections: | Research publications |
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