| Title |
Azithromycin and risk of COPD exacerbations in patients with and without Helicobacter pylori
|
|---|---|
| Published in |
Respiratory Research, May 2017
|
| DOI | 10.1186/s12931-017-0594-x |
| Pubmed ID | |
| Authors |
Seung Won Ra, Marc A. Sze, Eun Chong Lee, Sheena Tam, Yeni Oh, Nick Fishbane, Gerard J. Criner, Prescott G. Woodruff, Stephen C. Lazarus, Richard Albert, John E. Connett, Meilan K. Han, Fernando J. Martinez, Shawn D. Aaron, Robert M. Reed, S. F. Paul Man, Don D. Sin, on behalf of the Canadian Respiratory Research Network |
| Abstract |
Helicobacter pylori (HP) infection is associated with reduced lung function and systemic inflammation in chronic obstructive pulmonary disease (COPD) patients. Azithromycin (AZ) is active against HP and reduces the risk of COPD exacerbation. We determined whether HP infection status modifies the effects of AZ in COPD patients. Plasma samples from 1018 subjects with COPD who participated in the Macrolide Azithromycin (MACRO) in COPD Study were used to determine the HP infection status at baseline and 12 months of follow-up using a serologic assay. Based on HP infection status and randomization to either AZ or placebo (PL), the subjects were divided into 4 groups: HP+/AZ, HP-/AZ, HP+/PL, and HP-/PL. Time to first exacerbation was compared across the 4 groups using Kaplan-Meier survival analysis and a Cox proportional hazards model. The rates of exacerbation were compared using both the Kruskal-Wallis test and negative binomial analysis. Blood biomarkers at enrolment and at follow-up visits 3, 12, and 13 (1 month after treatment was stopped) months were measured. One hundred eighty one (17.8%) patients were seropositive to HP. Non-Caucasian participants were nearly three times more likely to be HP seropositive than Caucasian participants (37.4% vs 13.6%; p < 0.001). The median time to first exacerbation was significantly different across the four groups (p = 0.001) with the longest time in the HP+/AZ group (11.2 months, 95% CI; 8.4-12.5+) followed by the HP-/AZ group (8.0 months, 95% CI; 6.7-9.7). Hazard ratio (HR) for exacerbations was lowest in the HP+/AZ group after adjustment for age, sex, smoking status, ethnicity, history of peptic ulcer, dyspnea, previous hospital admission, GOLD grade of severity, and forced vital capacity (HR, 0.612; 95% CI, 0.442-0.846 vs HR, 0.789; 95% CI, 0.663-0.938 in the HP-/AZ group). Circulating levels of soluble tumor necrosis factor receptor-75 were reduced only in the HP+/AZ group after 3 months of AZ treatment (-0.87 ± 0.31 μg/L; p = 0.002); levels returned to baseline after discontinuing AZ. AZ is effective in preventing COPD exacerbations in patients with HP seropositivity, possibly by modulating TNF pathways related to HP infection. |
X Demographics
The data shown below were collected from the profiles of 14 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 5 | 36% |
| Canada | 2 | 14% |
| New Zealand | 1 | 7% |
| United States | 1 | 7% |
| Unknown | 5 | 36% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 71% |
| Practitioners (doctors, other healthcare professionals) | 3 | 21% |
| Scientists | 1 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 72 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 72 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 11 | 15% |
| Student > Ph. D. Student | 6 | 8% |
| Student > Master | 6 | 8% |
| Other | 5 | 7% |
| Student > Doctoral Student | 5 | 7% |
| Other | 13 | 18% |
| Unknown | 26 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 31% |
| Nursing and Health Professions | 6 | 8% |
| Immunology and Microbiology | 3 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 4% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Other | 11 | 15% |
| Unknown | 25 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 June 2018.
All research outputs
#4,809,771
of 25,382,440 outputs
Outputs from Respiratory Research
#601
of 3,062 outputs
Outputs of similar age
#78,594
of 329,744 outputs
Outputs of similar age from Respiratory Research
#26
of 80 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done well and is in the 80th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,062 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.9. This one has done well, scoring higher than 80% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 329,744 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 76% of its contemporaries.
We're also able to compare this research output to 80 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.