- In older patients with COPD, doxycycline added on to corticosteroid reduces treatment failure (acute exacerbation; AECOPD) by 23% in the short term (15-31 days of initiation).
- However, no reductions were seen in this population in the long term (approximately 12 months) or in all-ages analyses.
Why this matters
- This analysis is the first for doxycycline add-on for AECOPD using real-world evidence.
- A retrospective cohort study of pharmacy claims for 6300 adult primary care outpatients in the Netherlands who received either doxycycline (n=2261) or no antibiotic (n=4039) added on to corticosteroid (40 mg daily for 5 days or 30 mg daily for 7 days).
- Primary outcome: treatment failure, AECOPD in the short- and long-term.
- Funding: University of Groningen.
- No difference between doxycycline and no-antibiotic groups in short-term risk for treatment failure across all age groups combined.
- However, an older subgroup (aged 75+ years) had a 23% reduced risk for treatment failure with add-on doxycycline:
- 16.1% vs 19.9% in no-antibiotic group.
- Adjusted OR, 0.77 (95% CI, 0.62-0.97).
- Groups did not differ in long-term risk (median time to next exacerbation), regardless of age.
- Retrospective, observational design.
- Reliance on pharmacy claims data.