CFDB - Cystic Fibrosis DataBase

primary studies published RCT

Long-Term Pulmonal Therapy of Cystic Fibrosis-Patients with Amitriptyline.

Study design (if review, criteria of inclusion for studies)

two phase II randomised, double-blind, placebo-controlled studies.

Participants

CF patients

Interventions

Patients were treated with 25 mg amitriptyline twice daily, i.e. a total dose of 50 mg/d. After those two studies part of the patients used amitriptyline in an off-lable-use for routine treatment. These patients were observed after one, two and three years after continuous use of amitriptyline and were matched with those patients who were not treated. These patients were used as a control group.

Outcome measures

FEV1; weight.

Main results

After one year of treatment, forced expiratory volume in 1 sec predicted (FEV1) increased significantly by 7.6+/-7.0%, p=<0.001, and weight increased by 2.1+/-2.3kg, p=<0.001 in the amitriptyline population (n=20), whereas FEV1 decreased significantly in the control group by 1.8+/-3.3%, p=0.010, and weight increased by 1.1+/-2.7kg, p=0.010 (n=14). After two years of treatment, FEV1 increased significantly by 5.6+/-10.3%, p=0.009, and weight increased by 3.6+/-2.9kg, p=<0.001 in the amitriptyline population (n=12). In contrast, FEV1 decreased in the control group by 2.1+/-3.7%, p=0.051 and weight increased by only 0.4+/-2.9kg, p=0.31 (n=10). After three years of treatment, FEV1 increased significantly by 7.7+/-8%, p=0.050, and weight increased by 7.3+/-3.8kg, p=0.016, in the amitriptyline population (n=5), whereas FEV1 decreased in the control group by 1.0+/-1.3%, p=0.075 and weight increased by 0.4+/-1.5kg, p=0.29 (n=5).

Authors' conclusions

Amitriptyline significantly increases FEV1, reduces ceramide in lung cells and increases weight of CF patients.

Keywords: Adult; Amitriptyline; Anti-Bacterial Agents; Anti-Inflammatory Agents; Bacterial Infections; Infection; pharmacological_intervention; Pseudomonas aeruginosa; Pseudomonas; Respiratory Tract Diseases; Respiratory Tract Infections; Anti-Inflammatory Agents - excl Steroids;