title: Long-term efficacy of macrolide treatment in idiopathic pulmonary fibrosis: a retrospective analysis.
abstract: OBJECTIVE
  There is growing evidence for anti-inflammatory activities of macrolides in chronic respiratory diseases, such as diffuse panbronchiolitis, cystic fibrosis, or chronic bronchitis. The long-term effect of macrolides in idiopathic pulmonary fibrosis (IPF) is unknown. This study was aimed to investigate the effect of macrolide therapy on the frequency of acute exacerbation (AE) and the mortality in IPF.
  
  
  METHODS
  A total 52 IPF patients who were treated by combination of conventional agents with or without macrolides were retrospectively reviewed. The primary endpoint was the incidence of AE in IPF patients. We also observed survival rate after the treatment with or without macrolides.
  
  
  RESULTS
  AE was observed in 4 of 29 cases (13.8%) treated with macrolides and 8 of 23 cases (34.8%) treated without macrolides, respectively during 36 months. AE free survival rate of macrolide group was significantly better than that of non-macrolide group (logrank p=0.027). Survival rate of IPF patients with macrolide therapy was significantly better than that of patients without macrolide therapy (p=0.047).
  
  
  CONCLUSIONS
  Our results indicate the potential beneficial efficacy of macrolide therapy combined with oral corticosteroids, immunosuppressive or anti-fibrotic agents in IPF.
authors.affiliation: Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School. nao-k-u@nms.ac.jp.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kuse
authors.forename: Shinji
authors.initials: S
authors.lastname: Abe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kamio
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Saito
authors.forename: Jiro
authors.initials: J
authors.lastname: Usuki
authors.forename: Arata
authors.initials: A
authors.lastname: Azuma
authors.forename: Shoji
authors.initials: S
authors.lastname: Kudoh
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gemma
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D018942:Macrolides
keywords: idiopathic pulmonary fibrosis (IPF), acute exacerbation (AE), macrolides