6/27/23, 11:44 PM BLESS Pathway Feedback Search Clinical Topics Home Studies BLESS BLESS Disease Bronchiectasis Trial question What is the role of low-dose erythromycin in patients with non-cystic fibrosis bronchiectasis? Study design Multi-center Double blinded RCT Population Characteristics of study participants 58.8% female N = 679 41.2% male 679 patients (71 female, 46 male) Inclusion criteria: patients with non-cystic fibrosis bronchiectasis with a history of 2 infective exacerbations in the preceding year Key exclusion criteria: CF, current mycobacterial disease or bronchopulmonary aspergillosis, reversible cause for exacerbations, maintenance oral antibiotic prophylaxis, prior macrolide use except short-term, or cigarette smoking within 6 months Interventions N=59 erythromycin (BID erythromycin ethylsuccinate 400 mg for 48 weeks, followed by a 4- weeks washout period) N=58 placebo (matching placebo BID) Primary outcome Pulmonary exacerbations 2.0/ p-y 1.97 https://web.pathway.md/studies/rec7OmJ0SRuvEoTOt 1/2 6/27/23, 11:44 PM BLESS Pathway 1.5/ p-y 1.29 1.0/ p-y 0.5/ p-y Significant decrease 0.0/ p-y Erythromycin Placebo Significant decrease in pulmonary exacerbations (1.29 / p-y vs. 1.97 / p-y; IRR 0.57, 95% CI 0.42 to 0.77) Secondary outcomes Significant increase in macrolide-resistant oropharyngeal streptococci (27.7% vs. 0.04%; AD 25.5%, 95% CI 10.37 to 40.63) Safety outcomes Significant difference in adverse events (28.8% vs. 25.9%). Conclusion In patients with non-cystic fibrosis bronchiectasis with a history of 2 infective exacerbations in the preceding year, erythromycin was superior to placebo with respect to pulmonary exacerbations. Reference Serisier DJ, Martin ML, McGuckin MA et al. Effect of long-term, low-dose erythromycin on pulmonary exacerbations among patients with non-cystic fibrosis bronchiectasis: the BLESS randomized controlled trial. JAMA. 2013 Mar 27;309(12):1260-7. Open reference URL https://web.pathway.md/studies/rec7OmJ0SRuvEoTOt 2/2