Macrolides reduce exacerbations when added to inhaled therapy in severe asthma. However, there is little published evidence for effectiveness in patients treated with biologics. We conducted a retrospective audit of all patients who started azithromycin while on biologics in our centre. Compared with those that did not start azithromycin, these individuals had more exacerbations and a phenotype of chronic bronchitis and/or frequent purulent exacerbations. The addition of azithromycin to biologics was associated with reduced annual rates of steroid-treated and antibiotic-treated exacerbations and improved symptom scores (Asthma Control Questionnaire-5) but not with any improvement in lung function. Data support testing azithromycin in clinical trials in patients on biologics with residual exacerbations.

中文翻译：

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阿奇霉素联合单克隆抗体治疗对重度嗜酸性粒细胞性哮喘的影响


大环内酯类药物加入吸入治疗可减轻严重哮喘的恶化。然而，几乎没有已发表的证据表明对接受生物制剂治疗的患者有效。我们对在我们中心开始服用阿奇霉素的所有患者进行了回顾性检查。与未开始使用阿奇霉素的患者相比，这些个体的病情恶化更多，并且具有慢性支气管炎和/或频繁脓性恶化的表型。在生物制剂中添加阿奇霉素与类固醇治疗和抗生素治疗急性发作的年发生率降低以及症状评分改善相关 （哮喘控制问卷-5），但与肺功能的任何改善无关。数据支持在临床试验中对有残留恶化的生物制剂患者进行阿奇霉素测试。