Intermittent roxithromycin for preventing progression of small abdominal aortic aneurysms: long-term results of a small clinical trial.
BACKGROUND
Antibodies against Chlamydia pneumoniae are associated with an increased rate of expansion of small abdominal aortic aneurysms (AAAs). Short-term follow-up trials have shown a transient reduction AAA growth rate, in macrolide treated compared with placebo. Therefore we analysed the influence of intermittent, long-term roxithromycin treatment on AAA expansion and referral for surgery.


METHODS
Eighty-four patients with small AAAs were randomized to either an annual 4 weeks' treatment with roxithromycin or placebo, and followed prospectively.


RESULTS
Intermittent, long-term Roxithromycin-treatment reduced mean annual growth rate by 36% compared with placebo after adjustment for potential confounders. Long-term roxithromycin-treated patients had a 29% lower risk of being referred for surgical evaluation, increasing to 57% after adjusting for potential confounders.


CONCLUSIONS
Annual 4 week treatment with 300 mg roxithromycin daily may reduce the progression of small AAAs, and later need for surgical repair. However, more robust studies are needed for confirmation.
Høgh
Annette
A
Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Denmark. a_l_hogh@yahoo.dk
Vammen
Steen
S
Ostergaard
Lars
L
Joensen
Jette B
JB
Henneberg
Esklid W
EW
Lindholt
Jes S
JS
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017544:Aortic Aneurysm, Abdominal / Q000188:drug therapy* / Q000473:pathology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015575:Roxithromycin / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D015575:Roxithromycin