Bronchiectasis and asthma: Data from the European Bronchiectasis Registry (EMBARC).
J Allergy Clin Immunol
; 153(6): 1553-1562, 2024 Jun.
Article
in En
| MEDLINE
| ID: mdl-38401857
ABSTRACT
BACKGROUND:
Asthma is commonly reported in patients with a diagnosis of bronchiectasis.OBJECTIVE:
The aim of this study was to evaluate whether patients with bronchiectasis and asthma (BE+A) had a different clinical phenotype and different outcomes compared with patients with bronchiectasis without concomitant asthma.METHODS:
A prospective observational pan-European registry (European Multicentre Bronchiectasis Audit and Research Collaboration) enrolled patients across 28 countries. Adult patients with computed tomography-confirmed bronchiectasis were reviewed at baseline and annual follow-up visits using an electronic case report form. Asthma was diagnosed by the local investigator. Follow-up data were used to explore differences in exacerbation frequency between groups using a negative binomial regression model. Survival analysis used Cox proportional hazards regression.RESULTS:
Of 16,963 patients with bronchiectasis included for analysis, 5,267 (31.0%) had investigator-reported asthma. Patients with BE+A were younger, were more likely to be female and never smokers, and had a higher body mass index than patients with bronchiectasis without asthma. BE+A was associated with a higher prevalence of rhinosinusitis and nasal polyps as well as eosinophilia and Aspergillus sensitization. BE+A had similar microbiology but significantly lower severity of disease using the bronchiectasis severity index. Patients with BE+A were at increased risk of exacerbation after adjustment for disease severity and multiple confounders. Inhaled corticosteroid (ICS) use was associated with reduced mortality in patients with BE+A (adjusted hazard ratio 0.78, 95% CI 0.63-0.95) and reduced risk of hospitalization (rate ratio 0.67, 95% CI 0.67-0.86) compared with control subjects without asthma and not receiving ICSs.CONCLUSIONS:
BE+A was common and was associated with an increased risk of exacerbations and improved outcomes with ICS use. Unexpectedly we identified significantly lower mortality in patients with BE+A.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Asthma
/
Bronchiectasis
/
Registries
Limits:
Adult
/
Aged
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Female
/
Humans
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Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Year:
2024
Type:
Article