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COPD breathing relief from a pill?

February 6, 2012 12:00:00 AM PST
COPD is the third-leading cause of death in the United States. Twelve-million Americans have been diagnosed with the condition, which some know as emphysema or chronic bronchitis. Millions more may have COPD and not realize it. Now a pill may help people breathe easier. An antibiotic a day could help keep attacks at bay.

Chronic Obstructive Pulmonary Disease (COPD) is a serious lung disease that clogs airways, causing a chronic cough and a lot of phlegm. Severe symptoms can often flare up suddenly.

"There's been a sense for years that these flares in at least a group of patients with COPD are related to bacterial infections of the lung," said Dr. Fernando Martinez, director of Pulmonary Diagnostic Services at the University of Michigan Health System.

Dr. Martinez is among a group of nationwide researchers studying COPD and the effects of a common antibiotic on the condition. For one year, 570 trial participants took daily doses of the drug azithromycin in addition to their other COPD treatments.

"We were able to demonstrate that you could significantly decrease by more than 20 percent the rate of these flare-ups in at-risk people," said Martinez.

The daily regimen benefits those with moderate to severe symptoms.

Researchers say they were concerned that patients on the daily regimen would develop antibiotic resistance. While the drugs did increase the amount of antibiotic-resistant microbes in some patients, there were no infections reported. Still, more studies will be needed to look at the long-term effects of the antibiotic treatment.

WHAT IS COPD? Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases that make breathing extremely difficult. There are two main forms of COPD: Chronic bronchitis, which consists of a long-term cough with mucus and the second is emphysema, which involves destruction of the lungs over time. People with COPD usually have a combination of both conditions. At least 13 million people, in the United States alone, suffer from a form of COPD.

CAUSES: Smoking is the leading cause of COPD. The more a person smokes, the more likelihood that person will develop a form of COPD. In rare cases, nonsmokers who lack a protein called alpha-1 antitrypsin can develop emphysema.

OTHER RISKS FACTORS: Others factors that can contribute to COPD are: exposure to certain gases or fumes in the workplace; breathing in heavy amounts of secondhand smoke and pollution; and lighting a fire without having proper ventilation.

SYMPTOMS: Signs of COPD can consist of having a dry or wet cough; fatigue, shortness of breath (dyspnea) that gets worse with mild activity; having trouble catching one's breath; and wheezing.

BREAKTHROUGH STUDY: There is no cure for COPD, but a study is published in The New England Journal of Medicine showed a common antibiotic, called azithromycin, reduced the number of flare-ups in patients with COPD. In the study, 570 patients with COPD took 250 milligrams of azithromycin daily for a year, 572 others took a placebo pill that looked the same. Typically, a patient with COPD who has a flare-up is given a course of antibiotics, but not long-term. The researchers decided to look at the long-term treatment because similar regimens have shown promise in other lung diseases, including cystic fibrosis. Compared to placebo, the antibiotic reduced flare-ups by about 20 percent. At the one-year mark, those in the placebo group had on average 1.83 flare-ups, but those in the antibiotic group had 1.48.

PREVENTION: The best way to prevent COPD is by not smoking or by quitting smoking.


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