| Title: |
Bronchiectasis and asthma: Data from the European Bronchiectasis Registry (EMBARC) |
| Authors: |
Polverino E; Dimakou K; Traversi L; Bossios A; Haworth CS; Loebinger MR; De Soyza A; Vendrell M; Burgel P-R; Mertsch P; McDonnell M; Skrgat S; Maiz Carro L; Sibila O; van der Eerden M; Kauppi P; Hill AT; Wilson R; Milenkovic B; Menendez R; Murris M; Digalaki T; Crichton ML; Borecki S; Obradovic D; Nowinski A; Amorim A; Torres A; Lorent N; Welte T; Blasi F; Van Braeckel E; Altenburg J; Shoemark A; Shteinberg M; Boersma W; Elborn JS; Aliberti S; Ringshausen FC; Chalmers JD; Goeminne PC |
| Source: |
Journal of Allergy and Clinical Immunology, 2024 |
| Publisher Information: |
Elsevier Inc. |
| Publication Year: |
2024 |
| Collection: |
Newcastle University Library ePrints Service |
| Description: |
© 2024 The AuthorsBackground: 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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
https://eprints.ncl.ac.uk/297645; https://eprints.ncl.ac.uk/fulltext.aspx?url=297645/73BCAA82-6393-4BD2-BC90-2592482640BB.pdf&pub_id=297645 |
| Availability: |
https://eprints.ncl.ac.uk/297645 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.D936F994 |
| Database: |
BASE |