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Intermittent Roxithromycin for Preventing Progression of Small Abdominal Aortic Aneurysms: Long-Term Results of a Small Clinical Trial

Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Denmark, a_l_hogh{at}yahoo.dk

Steen Vammen, MD, PhD

Department of Vascular Surgery, , Skejby Sygehus, University hospital of Aarhus, Denmark

Lars Ostergaard, MD

2 Department of Infectious Diseases, Skejby Sygehus, University hospital of Aarhus, Denmark

Jette B. Joensen, MD, PhD

Department of Vascular Surgery, Rigshospitalet, Denmark

Esklid W. Henneberg, MD

Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Denmark

Jes S. Lindholt, MD, PhD

Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Denmark

Background: Antibodies against Chlamydia pneumoniae are associated with an increased rate of expansion of small abdominal aortic aneurysms (AAAs). Short-term follow-up trials have shown a transient reduction AAA growth rate, in macrolide treated compared with placebo. Therefore we analysed the influence of intermittent, long-term roxithromycin treatment on AAA expansion and referral for surgery. Methods: Eighty-four patients with small AAAs were randomized to either an annual 4 weeks’ treatment with roxithromycin or placebo, and followed prospectively. Results: Intermittent, long-term Roxithromycin-treatment reduced mean annual growth rate by 36% compared with placebo after adjustment for potential confounders. Long-term roxithromycin-treated patients had a 29% lower risk of being referred for surgical evaluation, increasing to 57% after adjusting for potential confounders. Conclusion: Annual 4 week treatment with 300 mg roxithromycin daily may reduce the progression of small AAAs, and later need for surgical repair. However, more robust studies are needed for confirmation.

Key Words: abdominal aortic aneurysm • macrolide • prophylactic medicine • long-term follow-up

This version was published on October 1, 2009

Vascular and Endovascular Surgery, Vol. 43, No. 5, 452-456 (2009)
DOI: 10.1177/1538574409335037


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