Severe asthma attacks were reduced by 40 per cent in a national clinical trial led by HMRI, using an antibiotic tablet to fight inflammation.

Severe asthma attacks were reduced by 40 per cent in a national clinical trial led by Hunter Medical Research Institute researchers, examining the innovative use of an antibiotic tablet to fight inflammation.

A low daily dosage of Azithromycin, a macrolide antibiotic, was provided to 420 patients in the AMAZES (Asthma and Macrolides: Azithromycin Efficacy and Safety) study conducted at Newcastle’s John Hunter Hospital, three sites in Sydney, plus Brisbane, Adelaide and Perth.

Results published today in leading international journal The Lancet show the new treatment benefited asthma sufferers whose symptoms were unresponsive to standard preventer medications comprising corticosteroids and long-acting beta2-agonists.

“This is an additional controller in simple tablet form for patients who often struggle with their asthma management, so we’re extremely pleased with the results,” lead researcher Professor Peter Gibson said.

“The treatment has the potential to decrease the number of exacerbations resulting in hospitalisation or prednisone (corticosteroid) use, and to greatly enhance quality of life.”

Where current asthma medications target the eosinophil cell, the antibiotic therapy is designed to reduce inflammation caused by a different cell, called a neutrophil. These help fight infection, yet in some patients with airways disease they induce excessive and persistent inflammation and poor lung function.

Common asthma triggers include allergens like dust and pollen, viruses such as the common cold, along with humid weather and rapid temperature changes.

Study participants were monitored for 48 weeks while receiving the oral antibiotic or placebo. They continued taking their regular asthma medications during the trial.

“There is appropriate concern regarding antibiotic use,” Professor Gibson adds. “While we found fewer infections in the patients, the use of Azithromycin needs to be selective in order to prevent concerns about antibiotic resistance.

“We have ongoing opportunities to find out precisely how the mechanism works and how to best identify responders. We can also develop the therapy further – possibly as an inhaler.”

AMAZES was the largest study of this treatment method in the world. Hunter Valley firm Tomago Aluminium provided seed-funding in 2003 and the Phase 2 trial received $2.9 million from the National Health and Medical Research Council (NHMRC).

AMAZES was a multicentre trial led by Professor Peter Gibson and Professor Jodie Simpson from the University of Newcastle and Hunter New England Health, researching with HMRI’s VIVA Program. HMRI works in partnership with the University of Newcastle, Hunter New England Health and the community.