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  • A new dawn: inhaled antibiotics for patients with bronchiectasis

    Author(s)
    Grimwood, Keith
    Chang, Anne B
    Griffith University Author(s)
    Grimwood, Keith
    Year published
    2019
    Metadata
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    Abstract
    The absence of licensed medications for non-cystic fibrosis bronchiectasis is concerning in the context of the high and increasing burden of bronchiectasis in adults 1 and children. 2 In The Lancet Respiratory Medicine , Charles Haworth and colleagues 3 report promising data from two double-blind randomised controlled trials (ORBIT-3 and ORBIT-4) examining the efficacy of a once-daily inhaled antibiotic composed of liposome-encapsulated ciprofloxacin and free ciprofloxacin (ARD-3150), which is a welcome advancement in the bronchiectasis field in which few such trials exist. 4 In ORBIT-3 and ORBIT-4, 3 Haworth and ...
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    The absence of licensed medications for non-cystic fibrosis bronchiectasis is concerning in the context of the high and increasing burden of bronchiectasis in adults 1 and children. 2 In The Lancet Respiratory Medicine , Charles Haworth and colleagues 3 report promising data from two double-blind randomised controlled trials (ORBIT-3 and ORBIT-4) examining the efficacy of a once-daily inhaled antibiotic composed of liposome-encapsulated ciprofloxacin and free ciprofloxacin (ARD-3150), which is a welcome advancement in the bronchiectasis field in which few such trials exist. 4 In ORBIT-3 and ORBIT-4, 3 Haworth and colleagues enrolled 278 (ORBIT-3) and 304 (ORBIT-4) patients with non-cystic fibrosis bronchiectasis who were chronically infected with Pseudomonas aeruginosa . Patients were randomly assigned (2:1) to receive either ARD-3150 or placebo, which was self-administered once daily for six 56-day treatment cycles, for 48 weeks. 3 The primary endpoint was time to the first pulmonary exacerbation from the date of randomisation to week 48. Treatment with ARD-3150 resulted in a significant prolongation of median time to first pulmonary exacerbation in ORBIT-4 of 230 days compared with 158 days in the placebo group, a difference of 72 days (hazard ratio 0·72 [95% CI 0·53–0·97], p=0·032), but no significant prolongation was observed in ORBIT-3 or a pooled analysis of both trials. Secondary and post-hoc analyses of pooled data revealed significant risk reductions in exacerbation frequency and severity in those receiving ARD-3150, and significant reductions in sputum P aeroginosa density during active treatment cycles, but no between-group changes in quality of life or lung function. 3
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    Journal Title
    Lancet Respiratory Medicine
    Volume
    7
    Issue
    3
    DOI
    https://doi.org/10.1016/S2213-2600(18)30456-9
    Subject
    Clinical sciences
    Other health sciences
    Science & Technology
    Life Sciences & Biomedicine
    Critical Care Medicine
    Respiratory System
    General & Internal Medicine
    Publication URI
    http://hdl.handle.net/10072/386784
    Collection
    • Journal articles

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