Asthma Clinical Trial
The ASTHMA Pilot Study is a randomized, controlled, parallel group clinical trial of 6
weekly doses of azithromycin (cumulative dose 4800 mg) or placebo as adjunctive treatment in
addition to usual care for adults with stable persistent asthma, with final follow up at 3
months after completion of study medication.
The hypothesis to be tested is that antibiotic treatment will improve asthma at followup,
and that this improvement will be limited to patients with evidence of C. pneumoniae
infection.
The secondary hypothesis is that randomized, controlled treatment trials can be carried out
successfully in a geographically dispersed practice-based research network.
Asthma is a chronic inflammatory bronchial condition of unknown etiology. Decades ago many
clinicians believed that infection played a major role in asthma etiology, but current
expert opinion favors the view that asthma is a noninfectious condition whose root cause is
inflammation. Therefore chronic antiinflammatory therapy, mainly inhaled corticosteroids, is
currently advocated as primary anti-asthma treatment. It is important to recognize, however,
that antiinflammatory therapy is palliative, not curative.
A growing body of evidence implicates chronic bronchial infection with Chlamydia pneumoniae
in the pathogenesis of asthma in both adults and children. Organism identification studies
(culture and PCR) suggest that up to one-half of children with asthma may be chronically
infected by C. pneumoniae, and seroepidemiologic studies in adults are consistent with
chronic C. pneumoniae infection in the majority of adult-onset asthmatics. Furthermore, case
reports and uncontrolled trials have provided provocative but inconclusive evidence that
treatment of C. pneumoniae infection in both children and adults with asthma can favorably
affect the natural history of this disorder.
We propose a randomized, placebo-controlled, triple-blinded study of antichlamydial
antimicrobial therapy in adult-onset asthma. Results will help to determine whether
antimicrobial therapy is effective in treating some adult asthma syndromes. Positive results
would have significant public health implications. Methodologies developed for use in this
trial may expedite future studies in practice-based research networks.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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|---|---|---|---|
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||
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