Lung clearance index to detect the efficacy of Aztreonam lysine inhalation in patients with cystic fibrosis and near normal spirometry – A single-centre feasibility study
Autoři:
Helmut Ellemunter aff001; Gratiana Steinkamp aff001
Působiště autorů:
Cystic Fibrosis (CF) Centre at the Medical University of Innsbruck, Innsbruck, Austria
aff001; Clinical Research and Medical Scientific Writing, Schwerin, Germany
aff002
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0221673
Souhrn
Comparing the efficacy of inhaled antibiotics can be difficult in small groups of patients with cystic fibrosis and mild lung disease. In a feasibility study we compared Aztreonam lysine for inhalation solution (AZLI; Cayston®) to standard inhaled antibiotic therapy in patients with cystic fibrosis and near normal spirometry. To detect treatment responses we used both lung clearance index (LCI) and forced expiratory volume in one second (FEV1). At baseline, median FEV1 was 87% pred. and median LCI was 8.6 (upper limit of normal: 7.0). After 4 weeks, LCI improved by -0.36 after AZLI and deteriorated by +0.12 after tobramycin treatment (p = 0.039). No significant differences between treatments (p = 0.195) were observed using FEV1. These results suggest that lung clearance index can be used to detect treatment induced changes in subjects with mild lung disease.
Klíčová slova:
Biology and life sciences – Biochemistry – Organisms – Physical sciences – Chemistry – Research and analysis methods – Proteins – Developmental biology – Medicine and health sciences – Chemical compounds – Microbiology – Medical microbiology – Microbial pathogens – Bacterial pathogens – Pseudomonas aeruginosa – Bacteria – Pseudomonas – Pathology and laboratory medicine – Pathogens – Physiology – Amino acids – Organic compounds – Organic chemistry – Pharmacology – Physiological processes – Pulmonology – Respiratory infections – Microbial control – Antimicrobials – Antibiotics – Drugs – Fibrosis – Bioassays and physiological analysis – Clinical genetics – Genetic diseases – Autosomal recessive diseases – Cystic fibrosis – Respiration – Inhalation – Respiratory physiology – Basic amino acids – Lysine – Respiratory analysis – Spirometry
Zdroje
1. Retsch-Bogart GZ, Burns JL, Otto KL, Liou TG, McCoy K, Oermann C et al. (2008) A phase 2 study of aztreonam lysine for inhalation to treat patients with cystic fibrosis and Pseudomonas aeruginosa infection. Pediatric pulmonology 43 (1): 47–58. doi: 10.1002/ppul.20736 18041081
2. Retsch-Bogart GZ, Quittner AL, Gibson RL, Oermann CM, McCoy KS, Montgomery AB et al. (2009) Efficacy and safety of inhaled aztreonam lysine for airway pseudomonas in cystic fibrosis. Chest 135 (5): 1223–1232. doi: 10.1378/chest.08-1421 19420195
3. Hutchinson D, Barclay M, Prescott WA, Brown J (2013) Inhaled aztreonam lysine. An evidence-based review. Expert opinion on pharmacotherapy 14 (15): 2115–2124. doi: 10.1517/14656566.2013.831070 23992352
4. O'Neill K, Tunney MM, Johnston E, Rowan S, Downey DG, Rendall J et al. (2016) Lung clearance index in adults and children with cystic fibrosis. Chest.
5. Amin R, Subbarao P, Jabar A, Balkovec S, Jensen R, Kerrigan et al. (2010) Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function. Thorax 65 (5): 379–383. doi: 10.1136/thx.2009.125831 20435858
6. Amin R, Subbarao P, Lou W, Jabar A, Balkovec S, Jensen R et al. (2010) The effect of dornase alfa on ventilation inhomogeneity in patients with cystic fibrosis. Eur Respir J.
7. Ellemunter H, Fuchs SI, Unsinn KM, Freund MC, Waltner-Romen M, Steinkamp G et al. (2010) Sensitivity of lung clearance index and chest computed tomography in early cf lung disease. Respir Med 104 (12): 1834–1842. doi: 10.1016/j.rmed.2010.06.010 20637585
8. Lee TW, Brownlee KG, Conway SP, Denton M, Littlewood JM (2003) Evaluation of a new definition for chronic Pseudomonas aeruginosa infection in cystic fibrosis patients. J Cyst.Fibros. 2 (1): 29–34. doi: 10.1016/S1569-1993(02)00141-8 15463843
9. Fuchs SI, Eder J, Ellemunter H, Gappa M (2009) Lung clearance index: normal values, repeatability, and reproducibility in healthy children and adolescents. Pediatr Pulmonol 44 (12): 1180–1185. doi: 10.1002/ppul.21093 19911370
10. Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH et al. (2012) Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J 40 (6): 1324–1343. doi: 10.1183/09031936.00080312 22743675
11. Schmidt A, Wenninger K, Niemann N, Wahn U, Staab D (2009) Health-related quality of life in children with cystic fibrosis: validation of the German CFQ-R. Health Qual.Life Outcomes. 7: 97. doi: 10.1186/1477-7525-7-97 19954541
12. Subbarao P, Stanojevic S, Brown M, Jensen R, Rosenfeld M, Davis et al. (2013) Lung clearance index as an outcome measure for clinical trials in young children with cystic fibrosis. A pilot study using inhaled hypertonic saline. Am J Respir Crit Care Med 188 (4): 456–460. doi: 10.1164/rccm.201302-0219OC 23742699
13. Konstan MW, Flume PA, Kappler M, Chiron R, Higgins M, Brockhaus F et al. (2011) Safety, efficacy and convenience of tobramycin inhalation powder in cystic fibrosis patients. The EAGER trial. Journal of cystic fibrosis: official journal of the European Cystic Fibrosis Society 10 (1): 54–61.
14. Vandevanter DR, Geller DE (2011) Tobramycin administered by the TOBI((R)) Podhaler((R)) for persons with cystic fibrosis. A review. Medical devices (Auckland, N.Z.) 4: 179–188.
15. Kent L, Reix P, Innes JA, Zielen S, Le Bourgeois M, Braggion C et al. (2014) Lung clearance index: Evidence for use in clinical trials in cystic fibrosis. J Cyst Fibros 13 (2): 123–138. doi: 10.1016/j.jcf.2013.09.005 24315208
16. Ratjen F, Sheridan H, Lee P, Song T, Stone A, Davies JC et al. (2011) Lung clearance index as an outcome measure in cystic fibrosis clinical trials [Abstract 201]. Pediatr Pulmonol Suppl.
17. Subbarao P, Milla C, Aurora P, Davies JC, Davis SD, Hall GL et al. (2015) Multiple-Breath Washout as a Lung Function Test in Cystic Fibrosis. A Cystic Fibrosis Foundation Workshop Report. Annals of the American Thoracic Society 12 (6): 932–939. doi: 10.1513/AnnalsATS.201501-021FR 26075554
18. Tiddens HAWM, Puderbach M, Venegas JG, Ratjen F, Donaldson SH, Davis SD et al. (2015) Novel outcome measures for clinical trials in cystic fibrosis. Pediatric pulmonology 50 (3): 302–315. doi: 10.1002/ppul.23146 25641878
19. Assael BM, Pressler T, Bilton D, Fayon M, Fischer R, Chiron R et al. (2013) Inhaled aztreonam lysine vs. inhaled tobramycin in cystic fibrosis. A comparative efficacy trial. Journal of cystic fibrosis: official journal of the European Cystic Fibrosis Society 12 (2): 130–140.
20. Wainwright CE, Quittner AL, Geller DE, Nakamura C, Wooldridge JL, Gibson RL et al. (2011) Aztreonam for inhalation solution (AZLI) in patients with cystic fibrosis, mild lung impairment, and P. aeruginosa. Journal of cystic fibrosis: official journal of the European Cystic Fibrosis Society 10 (4): 234–242.
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