AI Article Synopsis
- The review aimed to assess the effectiveness of macrolides in treating asthma in adults and found mixed results.
- While macrolides helped improve asthma control and quality of life slightly, they did not significantly reduce severe exacerbations, improve lung function, or show major benefits over placebo.
- Overall, evidence is insufficient to recommend macrolides for adult asthma management despite some noted positive effects.
Article Abstract
Background: The efficacy of macrolides in the management of asthma has been studied but remains controversial. We conducted a systematic review and meta-analysis of macrolides in the management of adult patients with asthma.
Methods: Randomized controlled trials of macrolides used in adult patients with asthma were searched for in MEDLINE, EMBASE, PsycINFO, Cochrane Library, CINAHL, and Igaku Chuo Zasshi databases to evaluate the efficacy and safety of macrolides.
Results: Seventeen reports with macrolide treatment durations ranging from 6 to 48 weeks were included. Macrolides did not reduce exacerbations requiring hospitalization, severe exacerbations, or rescue use of short-acting beta-2 agonist inhalers; improve lung function; decrease peripheral blood or sputum neutrophil counts; or decrease fractional exhaled nitric oxide compared to placebo. Macrolides statistically improved asthma control and quality of life but by less than the minimal clinically important difference. Peripheral blood eosinophil counts as well as serum and sputum eosinophilic cationic protein concentrations were significantly decreased with macrolides compared to placebo. The improvement of asthma symptoms and airway hyperresponsiveness varied by study. The safety profile of macrolides was comparable to that of placebo.
Conclusions: Although macrolides have some useful clinical aspects, there is not sufficient evidence to recommend their use in the management of adult patients with asthma.
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| http://dx.doi.org/10.1016/j.alit.2024.01.002 | DOI Listing |
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