Add-on azithromycin reduces sputum cytokines in non-eosinophilic asthma: an AMAZES substudy

Add-on azithromycin (AZM) significantly reduces exacerbations in poorly controlled asthma irrespective of disease phenotype. In a predefined substudy of the original AMAZES protocol (500 mg, three times a week for 48 weeks), we report that AZM treatment reduces key sputum inflammatory proteins (interleukin (IL)-6, IL-1 beta and extracellular DNA), which is more evident in non-eosinophilic asthma (NEA). Moreover, AZM reduced Haemophilus influenzae load only in NEA. Our data support the anti-inflammatory effects of AZM in poorly controlled asthma. Prospective studies are required to identify patients that derive greatest benefit from AZM add-on therapy.

Automated summary

Add-on azithromycin significantly reduces exacerbations in poorly controlled asthma, especially in non-eosinophilic asthma, by reducing key sputum inflammatory proteins and Haemophilus influenzae load. Further prospective studies are needed to identify patients who would benefit most from AZM add-on therapy.