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Bronchiectasis and asthma: Data from the European Bronchiectasis Registry (EMBARC).
Polverino, Eva; Dimakou, Katerina; Traversi, Letizia; Bossios, Apostolos; Haworth, Charles S; Loebinger, Michael R; De Soyza, Anthony; Vendrell, Montserrat; Burgel, Pierre-Régis; Mertsch, Pontus; McDonnell, Melissa; Skrgat, Sabina; Maiz Carro, Luis; Sibila, Oriol; van der Eerden, Menno; Kauppi, Paula; Hill, Adam T; Wilson, Robert; Milenkovic, Branislava; Menendez, Rosario; Murris, Marlene; Digalaki, Tonia; Crichton, Megan L; Borecki, Sermin; Obradovic, Dusanka; Nowinski, Adam; Amorim, Adelina; Torres, Antoni; Lorent, Natalie; Welte, Tobias; Blasi, Francesco; Van Braeckel, Eva; Altenburg, Josje; Shoemark, Amelia; Shteinberg, Michal; Boersma, Wim; Elborn, J Stuart; Aliberti, Stefano; Ringshausen, Felix C; Chalmers, James D; Goeminne, Pieter C.
Affiliation
  • Polverino E; Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, CIBERES, Barcelona, Spain.
  • Dimakou K; Fifth Respiratory Department and Bronchiectasis Unit, General Hospital for Chest Diseases "Sotiria," Athens, Greece.
  • Traversi L; Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, CIBERES, Barcelona, Spain.
  • Bossios A; Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden; Division of Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
  • Haworth CS; Cambridge Centre for Lung Infection, Royal Papworth Hospital and University of Cambridge, Cambridge, United Kingdom.
  • Loebinger MR; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College London, London, United Kingdom.
  • De Soyza A; Population and Health Science Institute, Newcastle University, Newcastle, United Kingdom; NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle, United Kingdom.
  • Vendrell M; Department of Pulmonology, Girona Biomedical Research Institute Dr Josep Trueta University Hospital (IDIBGI), University of Girona, Girona, Spain.
  • Burgel PR; Department of Medicine V, University Hospital, LMU Munich, Munich, Germany; Department of Respiratory Medicine and French Cystic Fibrosis National Reference Center, Hôpital Cochin, AP-HP, Paris, France; Institut Cochin, Université Paris Cité, INSERM U1016, Paris, France.
  • Mertsch P; Department of Medicine V, University Hospital, LMU Munich, Munich, Germany; Comprehensive Pneumology Center, German Center for Lung Research (DZL), Munich, Germany.
  • McDonnell M; Department of Respiratory Medicine, Galway University Hospital, Galway, Ireland.
  • Skrgat S; University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia; Pulmonary Department, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.
  • Maiz Carro L; Chronic Bronchial Infection Unit, Pneumology Service, Ramón y Cajal Hospital, Alcalá de Henares University, Madrid, Spain.
  • Sibila O; Servicio de Neumología, Instituto Clínico de Respiratorio, Hospital Clínic Barcelona, August Pi Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain; CIBERES, ISCIII, Madrid, Spain.
  • van der Eerden M; Department of Respiratory Medicine, Erasmus MC, Rotterdam, The Netherlands.
  • Kauppi P; Heart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
  • Hill AT; Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
  • Wilson R; Cambridge Centre for Lung Infection, Royal Papworth Hospital and University of Cambridge, Cambridge, United Kingdom.
  • Milenkovic B; Clinic for Pulmonary Diseases, University Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.
  • Menendez R; Pneumology Department, Hospital Universitario y Politécnico La Fe-Instituto de Investigación Sanitaria La Fe, Valencia, Spain.
  • Murris M; Department of Respiratory Diseases, CHU de Toulouse, Toulouse, France.
  • Digalaki T; Fifth Respiratory Department and Bronchiectasis Unit, General Hospital for Chest Diseases "Sotiria," Athens, Greece.
  • Crichton ML; Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom.
  • Borecki S; Department of Pulmonology Diseases, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
  • Obradovic D; Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia; Institute for Pulmonary Diseases, Put doktora Goldmana 4, Sremska Kamenica, Serbia.
  • Nowinski A; Department of Epidemiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland.
  • Amorim A; Pulmonology Department, Centro Hospitalar Universitário São João and Faculty of Medicine, University of Porto, Porto, Portugal.
  • Torres A; Department of Pulmonology, Hospital Clinic, University of Barcelona, CIBERES, IDIBAPS, ICREA, Barcelona, Spain.
  • Lorent N; Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.
  • Welte T; Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage & Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany; European Reference Network on Rare and Complex Respiratory Diseases, Fr
  • Blasi F; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Van Braeckel E; Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
  • Altenburg J; Department of Pulmonary Diseases, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
  • Shoemark A; Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom.
  • Shteinberg M; Pulmonology Institute and CF Center, Carmel Medical Center, Haifa, Israel; B. Rappaport Faculty of Medicine, The Technion, Israel Institute of Technology, Haifa, Israel.
  • Boersma W; Department of Pulmonary Diseases, Northwest Clinics, Alkmaar, The Netherlands.
  • Elborn JS; Faculty of Medicine, Health and Life Sciences, Queen's University, Belfast, Northern Ireland.
  • Aliberti S; Respiratory Unit, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Ringshausen FC; Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage & Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany; European Reference Network on Rare and Complex Respiratory Diseases, Fr
  • Chalmers JD; Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom. Electronic address: j.chalmers@dundee.ac.uk.
  • Goeminne PC; Department of Respiratory Disease, AZ Nikolaas, Sint-Niklaas, Belgium.
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.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Asthma / Bronchiectasis / Registries Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: En Journal: J Allergy Clin Immunol Year: 2024 Type: Article Affiliation country: Spain
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Asthma / Bronchiectasis / Registries Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: En Journal: J Allergy Clin Immunol Year: 2024 Type: Article Affiliation country: Spain