Bronchiectasis and asthma: Data from the European Bronchiectasis Registry (EMBARC)

被引：14

作者：

Polverino, Eva ^{[1
]}

Dimakou, Katerina ^{[2
,3
]}

Traversi, Letizia ^{[1
]}

Bossios, Apostolos ^{[4
,5
]}

Haworth, Charles S. ^{[6
,7
]}

Loebinger, Michael R. ^{[8
]}

De Soyza, Anthony ^{[9
,10
]}

Vendrell, Montserrat ^{[11
]}

Burgel, Pierre-Regis ^{[12
,13
,14
,15
]}

Mertsch, Pontus ^{[16
]}

McDonnell, Melissa ^{[17
]}

Skrgat, Sabina ^{[18
,19
,20
]}

Carro, Luis Maiz ^{[21
]}

Sibila, Oriol ^{[22
,23
]}

van der Eerden, Menno ^{[24
]}

Kauppi, Paula ^{[25
]}

Hill, Adam T. ^{[26
]}

Wilson, Robert ^{[6
,7
]}

Milenkovic, Branislava ^{[27
,28
]}

Menendez, Rosario ^{[29
]}

Murris, Marlene ^{[30
]}

Digalaki, Tonia

Crichton, Megan L. ^{[31
,32
]}

Borecki, Sermin ^{[33
]}

Obradovic, Dusanka ^{[34
,35
]}

Nowinski, Adam ^{[36
]}

Amorim, Adelina ^{[37
,38
]}

Torres, Antoni ^{[39
]}

Lorent, Natalie ^{[40
]}

Welte, Tobias ^{[41
,42
,43
]}

Blasi, Francesco ^{[44
,45
]}

Van Braeckel, Eva ^{[46
,47
]}

Altenburg, Josje ^{[48
]}

Shoemark, Amelia ^{[32
]}

Shteinberg, Michal ^{[49
,50
,51
]}

Boersma, Wim ^{[52
]}

Elborn, J. Stuart ^{[53
]}

Aliberti, Stefano ^{[54
,55
]}

Ringshausen, Felix C.

Chalmers, James D.

Goeminne, Pieter C. ^{[56
]}

机构：

[1] Hosp Univ Vall dHebron, Vall dHebron Inst Recerca, Dept Pneumol, CIBERES, Barcelona, Spain

[2] Gen Hosp Chest Dis Sotiria, Resp Dept 5, Athens, Greece

[3] Gen Hosp Chest Dis Sotiria, Bronchiectasis Unit, Athens, Greece

[4] Karolinska Univ Hosp, Dept Resp Med & Allergy, Stockholm, Sweden

[5] Karolinska Inst, Inst Environm Med, Div Lung & Airway Res, Stockholm, Sweden

[6] Royal Papworth Hosp Cambridge, Cambridge Ctr Lung Infect, Cambridge, England

[7] Univ Cambridge, Cambridge, England

[8] Imperial Coll London, Royal Brompton & Harefield Hosp, Natl Heart & Lung Inst, London, England

[9] Newcastle Univ, Populat & Hlth Sci Inst, Newcastle Upon Tyne, England

[10] Freeman Rd Hosp, NIHR Biomed Res Ctr Ageing, Newcastle Upon Tyne, England

[11] Univ Girona, Girona Biomed Res Inst, Dept Pulmonol, Dr Josep Trueta Univ Hosp IDIBGI, Girona, Spain

[12] Hop Cochin, AP HP, Dept Resp Med, Paris, France

[13] Hop Cochin, AP HP, French Cyst Fibrosis Natl Reference Ctr, Paris, France

[14] Univ Paris Cite, Inst Cochin, INSERM U1016, Paris, France

[15] Ludwig Maximilians Univ Munchen, Dept Med, Univ Hosp, Munich, Germany

[16] German Ctr Lung Res DZL, Comprehens Pneumol Ctr, Munich, Germany

[17] Galway Univ Hosp, Dept Resp Med, Galway, Ireland

[18] Univ Clin Resp & Allerg Dis Golnik, Golnik, Slovenia

[19] Univ Ljubljana, Med Fac, Ljubljana, Slovenia

[20] Univ Med Ctr Ljubljana, Div Internal Med, Pulm Dept, Ljubljana, Slovenia

[21] Alcala de Henares Univ, Chron Bronchial Infect Unit, Pneumol Serv, Ramon y Cajal Hosp, Madrid, Spain

[22] Univ Barcelona, August Pi Sunyer Biomed Res Inst IDIBAPS, Inst Clin Resp, Hosp Clin Barcelona,Serv Neumol, Barcelona, Spain

[23] ISCIII, CIBERES, Madrid, Spain

[24] Erasmus MC, Dept Resp Med, Rotterdam, Netherlands

[25] Univ Helsinki, Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland

[26] Royal Infirm Edinburgh NHS Trust, Dept Resp Med, Edinburgh, Scotland

[27] Univ Clin Ctr Serbia, Clin Pulm Dis, Belgrade, Serbia

[28] Univ Belgrade, Sch Med, Belgrade, Serbia

[29] Hosp Univ Politecn La Fe, Pneumol Dept, Inst Invest Sanitaria La Fe, Valencia, Spain

[30] CHU Toulouse, Dept Resp Dis, Toulouse, France

[31] Univ Dundee, Ninewells Hosp, Div Mol & Clin Med, Dundee, Scotland

[32] Univ Dundee, Med Sch, Dundee, Scotland

[33] Istanbul Univ Cerrahpasa, Cerrahpasa Med Fac, Dept Pulmonol Dis, Istanbul, Turkiye

[34] Univ Novi Sad, Fac Med Novi Sad, Novi Sad, Serbia

[35] Inst Pulm Dis, Putdoktora Goldmana 4, Sremska Kamenica, Serbia

[36] Natl TB & Lung Dis Res Inst, Dept Epidemiol, Warsaw, Poland

[37] Uni Porto, Pulmonol Dept, Ctr Hosp Univ Sao Joao, Porto, Portugal

[38] Uni Porto, Fac Med, Porto, Portugal

[39] Univ Barcelona, Hosp Clin, Dept Pulmonol, CIBERES,IDIBAPS,ICREA, Barcelona, Spain

[40] Univ Hosp Leuven, Dept Resp Dis, Leuven, Belgium

[41] Hannover Med Sch, Dept Resp Med & Infect Dis, Hannover, Germany

[42] German Ctr Lung Res, Biomed Res Endstage Obstruct Lung Dis Hannover, Hannover, Germany

[43] European Reference Network Rare & Complex Resp Di, Frankfurt, Germany

[44] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[45] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Milan, Italy

[46] Univ Ghent, Dept Internal Med & Paediat, Fac Med & Hlth Sci, Ghent, Belgium

[47] Ghent Univ Hosp, Dept Resp Med, Ghent, Belgium

[48] Univ Amsterdam, Dept Pulmo Dis, Med Ctr, Amsterdam, Netherlands

[49] Carmel Hosp, Pulmonol Inst, Haifa, Israel

[50] Carmel Hosp, CF Ctr, Haifa, Israel

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY | 2024年 / 153卷 / 06期

关键词：

Asthma; registry; eosinophils; exacerbations; DIAGNOSIS;

D O I：

10.1016/j.jaci.2024.01.027

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

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 (BE1A) 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 BE1A were younger, were more likely to be female and never smokers, and had a higher body mass index than patients with bronchiectasis without asthma. BE1A was associated with a higher prevalence of rhinosinusitis and nasal polyps as well as eosinophilia and Aspergillus sensitization. BE1A had similar microbiology but significantly lower severity of disease using the bronchiectasis severity index. Patients with BE1A 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 BE1A (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: BE1A 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 BE1A.

引用

页码：1553 / 1562

页数：10

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