Aztreonam for inhalation solution in patients with non-cystic fibrosis bronchiectasis (AIR-BX1 and AIR-BX2): two randomised double-blind, placebo-controlled phase 3 trials

Barker, Alan F.; O’Donnell, Anne E.; Flume, Patrick A.; Thompson, Philip J.; Ruzi, Jonathan; Gracia, Javier de; Boersma, Wim; Soyza, Anthony De; Shao, Lixin; Zhang, Jenny; Haas, L. Chabrol; Lewis, Sandra A; Leitzinger, Sheila; Montgomery, A. Bruce; McKevitt, Matthew; Gossage, David L.; Quittner, Alexandra L.; O’Riordan, Thomas G.

doi:10.1016/s2213-2600(14)70165-1

Cited by 188 publications

(189 citation statements)

References 28 publications

Supporting

Mentioning

178

Contrasting

Unclassified

Order By: Relevance

“…First, the dose used was optimised for CF rather than bronchiectasis and future studies should consider specific dose-ranging studies in bronchiectasis. There were imbalances in the groups in AIR-BX1 in terms of the frequency of COPD and some markers of severity which may be relevant when considering respiratory tolerance [84]. Finally, the heterogeneity of the population in terms of aetiology, microbiology and severity may have contributed.…”

Section: Inhaled Antibioticsmentioning

confidence: 95%

“…Worsening of dyspnoea and cough were the major drivers of intolerance. The primary outcome was not reached, and secondary end-points such as exacerbations were also negative [84]. Several reasons for the failure of this treatment to translate into bronchiectasis can be speculated.…”

Section: Inhaled Antibioticsmentioning

confidence: 99%

“…Two recent phase III trials in bronchiectasis randomised 266 (AIR-BX1) and 274 (AIR-BX2) patients to aztreonam or placebo over the course of two 28-day treatment cycles (with 28 days off treatment between cycles) [84]. The primary outcome was the newly developed Quality of Life Bronchiectasis (QoL-B) questionnaire, the first disease specific instrument to be developed [85].…”

Section: Inhaled Antibioticsmentioning

confidence: 99%

See 2 more Smart Citations

Management of bronchiectasis in adults

2015

View full text Add to dashboard Cite

Formerly regarded as a rare disease, bronchiectasis is now increasingly recognised and a renewed interest in the condition is stimulating drug development and clinical research. Bronchiectasis represents the final common pathway of a number of infectious, genetic, autoimmune, developmental and allergic disorders and is highly heterogeneous in its aetiology, impact and prognosis.The goals of therapy should be: to improve airway mucus clearance through physiotherapy with or without adjunctive therapies; to suppress, eradicate and prevent airway bacterial colonisation; to reduce airway inflammation; and to improve physical functioning and quality of life.Fortunately, an increasing body of evidence supports interventions in bronchiectasis. The field has benefited greatly from the introduction of evidence-based guidelines in some European countries and randomised controlled trials have now demonstrated the benefit of long-term macrolide therapy, with accumulating evidence for inhaled therapies, physiotherapy and pulmonary rehabilitation.This review provides a critical update on the management of bronchiectasis focussing on emerging evidence and recent randomised controlled trials. @ERSpublications Bronchiectasis is a rapidly developing field: review of recent RCTs and progress towards developing new therapies

show abstract

Section: Inhaled Antibioticsmentioning

confidence: 95%

Section: Inhaled Antibioticsmentioning

confidence: 99%

Section: Inhaled Antibioticsmentioning

confidence: 99%

See 1 more Smart Citation

Management of bronchiectasis in adults

2015

View full text Add to dashboard Cite

show abstract

“…Several reports describe the long-term use of inhaled antibiotics in ∼10% and of macrolides in ∼30% of all bronchiectasis patients [50][51][52]. Various inhaled antibiotics have been tested to reduce bacterial load from bronchiectasis patients' airways, and related symptoms and exacerbations, such as tobramycin [53,54], colistin [55], gentamicin [56] and aztreonam [57]. In bronchiectasis, data on inhaled antibiotics are limited and results have been mixed, with tolerability being one of the major issues.…”

Section: Consensus Statements 1)mentioning

confidence: 99%

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

et al. 2016

Self Cite

View full text Add to dashboard Cite

Bronchiectasis is a disease of renewed interest in light of an increase in prevalence and increasing burden on international healthcare systems. There are no licensed therapies, and large gaps in knowledge in terms of epidemiology, pathophysiology and therapy. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) is a European Respiratory Society (ERS) Clinical Research Collaboration, funded by ERS to promote high-quality research in bronchiectasis. The objective of this consensus statement was to define research priorities in bronchiectasis. From 2014 to 2015, EMBARC used a modified Delphi process among European bronchiectasis experts to reach a consensus on 55 key research priorities in this field. During the same period, the European Lung Foundation collected 711 questionnaires from adult patients with bronchiectasis and their carers from 22 European countries reporting important research priorities from their perspective. This consensus statement reports recommendations for bronchiectasis research after integrating both physicians and patients priorities, as well as those uniquely identified by the two groups. Priorities identified in this consensus statement provide the clearest possible roadmap towards improving our understanding of the disease and the quality of care for patients with bronchiectasis. @ERSpublications EMBARC consensus statement identifies research priorities in bronchiectasis as determined by physicians and patients

show abstract

“…Two large, phase III clinical trials evaluating the efficacy of inhaled aztreonam in this patient population have been conducted. Unfortunately, both of these trials failed to show a clinical benefit, and the rates of adverse events were higher in the aztreonam group than in the placebo group (229).…”

Section: Non-cf Bronchiectasismentioning

confidence: 99%

Inhaled Antibiotics for Gram-Negative Respiratory Infections

et al. 2016

View full text Add to dashboard Cite

SUMMARYGram-negative organisms comprise a large portion of the pathogens responsible for lower respiratory tract infections, especially those that are nosocomially acquired, and the rate of antibiotic resistance among these organisms continues to rise. Systemically administered antibiotics used to treat these infections often have poor penetration into the lung parenchyma and narrow therapeutic windows between efficacy and toxicity. The use of inhaled antibiotics allows for maximization of target site concentrations and optimization of pharmacokinetic/pharmacodynamic indices while minimizing systemic exposure and toxicity. This review is a comprehensive discussion of formulation and drug delivery aspects,in vitroand microbiological considerations, pharmacokinetics, and clinical outcomes with inhaled antibiotics as they apply to disease states other than cystic fibrosis. In reviewing the literature surrounding the use of inhaled antibiotics, we also highlight the complexities related to this route of administration and the shortcomings in the available evidence. The lack of novel anti-Gram-negative antibiotics in the developmental pipeline will encourage the innovative use of our existing agents, and the inhaled route is one that deserves to be further studied and adopted in the clinical arena.

show abstract

Aztreonam for inhalation solution in patients with non-cystic fibrosis bronchiectasis (AIR-BX1 and AIR-BX2): two randomised double-blind, placebo-controlled phase 3 trials

Cited by 188 publications

References 28 publications

Management of bronchiectasis in adults

Management of bronchiectasis in adults

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

Inhaled Antibiotics for Gram-Negative Respiratory Infections

Contact Info

Product

Resources

About