Asthma is a common disease in Westernised societies, affecting up to 10% of the population.
Corticosteroids are the most effective treatment for asthma but the therapeutic response
varies considerably between individuals. A major cause of corticosteroid insensitivity in
asthma is cigarette smoking. Active cigarette smoking occurs in over 25% of adults with
asthma and a further 25% are ex-smokers. In a series of proof of concept clinical studies the
investigators demonstrated for the first time that the efficacy of inhaled and oral
corticosteroids is markedly impaired in smokers with asthma and to a lesser extent in
ex-smokers with asthma. Active cigarette smoking has other detrimental effects on asthma
morbidity including more severe symptoms, increased rates of hospitalisation, and accelerated
decline in lung function. Smoking cessation advice is often ineffective because many adult
smokers with asthma do not believe that they are personally at risk from their smoking, take
many years until stopping smoking and frequently restart smoking after quitting. Alternative
or additional drugs to corticosteroids are needed for smokers with asthma who are unable to
obtain the clinical benefits associated with stopping smoking. In a proof of concept clinical
trial the investigators will test the hypothesis that macrolides improve asthma control and
reduce sputum neutrophil counts of smokers with chronic asthma.
Phase:
Phase 3
Details
Lead Sponsor:
Euan J Cameron
Collaborators:
NHS Greater Glasgow and Clyde University of Glasgow