Sputum-Rheology-Based Strategy for Guiding Azithromycin Prescription in COPD Patients with Frequent Exacerbations: A Randomized, Controlled Study (“COPD CARhE”) - CNRS - Centre national de la recherche scientifique Accéder directement au contenu
Article Dans Une Revue Biomedicines Année : 2023

Sputum-Rheology-Based Strategy for Guiding Azithromycin Prescription in COPD Patients with Frequent Exacerbations: A Randomized, Controlled Study (“COPD CARhE”)

Zysman Maeva
  • Fonction : Auteur
Laurent Guilleminault
  • Fonction : Auteur
Mathilde Volpato
  • Fonction : Auteur
Aurelie Fort-Petit
Isabelle Vachier
Jeremy Patarin
Carey Suehs
Ahmed Engi
  • Fonction : Auteur
Nicolas Molinari
  • Fonction : Auteur

Résumé

(1) Background: We have previously shown that sputum rheology can discriminate between patients with COPD and other muco-obstructive lung diseases, and that it is correlated with mucin content and sputum eosinophilia. We now hypothesize that it could be a more-accurate guide than clinical evaluation for the prescription of azithromycin to prevent exacerbations of COPD and to reduce exposure to antibiotics; (2) Methods: “COPD CaRhe” is a multicentric, randomized, controlled trial comparing outcomes in two parallel arms (36 vs. 36 patients). Patients will be recruited in the university hospitals of Montpellier, Bordeaux, and Toulouse, in France, and they should have a diagnosis of COPD with frequent exacerbations (≥3/year). Enrollment will occur during a routine visit to a respiratory department, and follow-up visits will occur every 3 months for a period of 1 year. At each visit, a 3-month prescription of azithromycin will be provided to those patients who obtain a score of <70 on the Cough and Sputum Assessment Questionnaire (CASA-Q) or a critical stress score of σc > 39 on a rheological assessment of sputum, depending upon their randomization group. The primary outcome will be the number of exacerbations of COPD; (3) Discussion: By using sputum rheology, the COPD CaRhe study may provide clinicians with an objective biomarker to guide the prescription of azithromycin while reducing the cumulative exposure to macrolides.
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Dates et versions

hal-04015885 , version 1 (06-03-2023)

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Jérémy Charriot, Zysman Maeva, Laurent Guilleminault, Mathilde Volpato, Aurelie Fort-Petit, et al.. Sputum-Rheology-Based Strategy for Guiding Azithromycin Prescription in COPD Patients with Frequent Exacerbations: A Randomized, Controlled Study (“COPD CARhE”). Biomedicines, 2023, 11 (3), pp.740. ⟨10.3390/biomedicines11030740⟩. ⟨hal-04015885⟩
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