Macrolides for Asthma Management: An Updated Review

While macrolides had no direct effect on lung function, their use significantly improved asthma control and quality of life in patients with asthma.

This article is part of Pulmonology Advisor‘s coverage of the American Thoracic Society’s International Conference, taking place in San Diego, California. Our staff will report on medical research related to asthma and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from ATS 2018.

SAN DIEGO — The use of macrolide antibiotics had no effect on lung function but did improve asthma control, quality of life, and symptom scores significantly, according to research presented at the American Thoracic Society 2018 International Conference.

Macrolide antibiotics have been shown to exert antimicrobial and immunomodulatory effects on asthma, but study findings have been controversial. Researchers from West China Hospital in Chengdu, China, conducted a meta-analysis of available data to update the current evidence on the use of macrolides in the management of asthma

The analysis included randomized controlled trials of the use of macrolide therapy for patients with asthma. The authors included trials from PubMed, Embase, and Cochrane Central Register of Controlled Trials published up to October 2017. Reported outcomes included pulmonary function, quality of life scores, symptom scores, and asthma control. 

A total of 16 studies (N=1745) were reviewed for the analysis. The study authors found that macrolide treatment could improve asthma control (standard mean difference [SMD] -0.58; 95% CI, -1.15 to -0.01), quality of life (MD 0.16; 95% CI, 0.04-0.29), and symptom scores (MD -0.76; 95% CI, -1.29 to -0.23) significantly.

However, treatment with macrolides was not associated with improvement in lung function as measured by forced expiratory volume in 1 second (SMD 0.06; 95% CI, -0.06 to 0.28) and peak expiratory flow (MD 0.11; 95% CI, -0.02 to 0.24). 

Based on these findings, the authors concluded that additional trials are needed to assess clinically relevant outcomes such as asthma exacerbations, symptom score, and lung function.

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Wang F, Tang X, Sun L, et al. Macrolides for the treatment of asthma – an updated systematic review and meta-analysis. Presented at: American Thoracic Society 2018 International Conference; May 18-23, 2018; San Diego, CA. Abstract 1086.