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Azithromycin for prevention of exacerbations in non-cystic fibrosis bronchiectasis (EMBRACE): a randomised, double-blind, placebo-controlled trial
Azithromycin is a macrolide antibiotic with anti-inflammatory and immunomodulatory properties. We tested the hypothesis that azithromycin would decrease the frequency of exacerbations, increase lung function, and improve health-related quality of life in patients with non-cystic fibrosis bronchiectasis.
We undertook a randomised, double-blind, placebo-controlled trial at three centres in New Zealand. Between Feb 12, 2008, and Oct 15, 2009, we enrolled patients who were 18 years or older, had had at least one pulmonary exacerbation requiring antibiotic treatment in the past year, and had a diagnosis of bronchiectasis defined by high-resolution CT scan. We randomly assigned patients to receive 500 mg azithromycin or placebo three times a week for 6 months in a 1:1 ratio, with a permuted block size of six and sequential assignment stratified by centre. Participants, research assistants, and investigators were masked to treatment allocation. The coprimary endpoints were rate of event-based exacerbations in the 6-month treatment period, change in forced expiratory volume in 1 s (FEV1) before bronchodilation, and change in total score on St George's respiratory questionnaire (SGRQ). Analyses were by intention to treat. This study is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12607000641493.
71 patients were in the azithromycin group and 70 in the placebo group. The rate of event-based exacerbations was 0·59 per patient in the azithromycin group and 1·57 per patient in the placebo group in the 6-month treatment period (rate ratio 0·38, 95% CI 0·26–0·54; p<0·0001). Prebronchodilator FEV1 did not change from baseline in the azithromycin group and decreased by 0·04 L in the placebo group, but the difference was not significant (0·04 L, 95% CI −0·03 to 0·12; p=0·251). Additionally, change in SGRQ total score did not differ between the azithromycin (–5·17 units) and placebo groups (–1·92 units; difference −3·25, 95% CI −7·21 to 0·72; p=0·108).
Azithromycin is a new option for prevention of exacerbations in patients with non-cystic fibrosis bronchiectasis with a history of at least one exacerbation in the past year.
Health Research Council of New Zealand and Auckland District Health Board Charitable Trust.
Journal Article
Budesonide and risk of pneumonia/Authors' reply
[...] in the Methods section Sin and colleagues state that the sponsor had no role in the study design or collection, analysis, and interpretation of the data. [...] it should be noted that the term \"pneumonia\" reported in our analysis and in other published papers refers to events that are usually recorded by history only. [...] their clinical characteristics and importance remain to be fully defined.
Journal Article
CHART BEAT
Frenzy surrounding the FIFA World Cup helped Ian Broudie of The Lightning Seeds and comedians Frank Skiunner and David Baddiel make history on the Official UK Singles chart, where soccer anthem \"Three Lions\" returned to No. 1.
Trade Publication Article
The Tap-Dancing Genius Behind London's O2
REBECCA KANE, GM OF LONDON'S 02, confesses she's amused and surprised - not that the entertainment complex she runs on the Greenwich peninsula has rewritten the live-music record book, but that her love of tap dancing, a history degree at Cambridge and a stint as a concert booker for a stately home have led to her job at the most successful music venue of its size in the world. Since 2009, the 20,000-seat O2 Arena has topped its class on Billboard's yearend Boxscore charts. Kane, 38, manages the entire complex, which also houses the 2,700-capacity Indigo at the O2 and smaller venues (including a U.K. branch of Brooklyn Bowl), along with bars, restaurants and an exhibition space.
Trade Publication Article
Lateral's Next Move
Martin was the voice of Swedish House Mafia's global hit \"Don't You Worry Child,\" which topped the U.K. chart on Virgin/EMI last October and has sold 2.4 million downloads in the United States on Astralwerks/Capitol, according to Nielsen SoundScan.
Trade Publication Article
Streaming Taking Hold Globally
Deezer U.K. & Ireland managing director Mark Foster says, \"The recovery and future growth of the business requires streaming services like Deezer to develop profitable, long-term business models that deliver for all industry players. \" \"The recording industry is on the road to recovery,\" IFPI chief executive Frances Moore says, \"thanks to the success of new digital channels, its increasing ability to tap the potential of emerging markets, the diversification of its revenue streams and its continued investment in talent.
Trade Publication Article