Early Exacerbation Relapse is Increased in Patients with Asthma and Bronchiectasis (a post hoc analysis)

Andrew R Hill*, Pallavi Bedi, Manjit Cartlidge, Kim Turnbull, Samantha Donaldson, Andrea Clarke, Jane Crowe, Kadiga Campbell, Ruzanna Frangulyan, Adriano G Rossi, Adam Hill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Purpose: Asthma is a common comorbidity in patients with bronchiectasis and has been shown to increase the risk of bronchiectasis exacerbations. This paper explores the impact of comorbid asthma on patients receiving intravenous antibiotic treatment for bronchiectasis exacerbations.
Methods: This was a post hoc analysis of the Meropenem randomised controlled trial of 90 patients that had intravenous antibiotic treatment for bronchiectasis exacerbations. The participants were split into two groups: group 1 (asthma and bronchiectasis) and group 2 (bronchiectasis). The authors assessed response to treatment and time to next exacerbation.
Results: There were 38 participants in group 1 and 34 participants in group 2. The groups were found to be comparable in terms of age, sex, and bronchiectasis severity (median (95% CI) group 1 and then group 2 data): age 64.0(59.3, 68.6) and 63.6(57.9, 69.4) years old, p=0.8; 57.9% and 64.7% female, p=0.6; Bronchiectasis Severity Index 11.1(9.8, 12.4) and 10.1(8.2, 12.0), p=0.3. There was a similar response to treatment between the groups, but group 1 were found to relapse early by day 14, 31.6% in group 1 and 11.8% in group 2, p=0.03. In the Cox proportional hazards model, asthma was the only independent risk factor for early relapse by day 14 (odds ratio (95% CI) 3.16 (1.02 – 9.79), p=0.047).
Conclusion: The clinical response to treatment was similar but patients with co-existing asthma were at increased risk of early relapse within 14 days of stopping intravenous antibiotic therapy. Clinical Trial Registration: NCT02047773
Original languageEnglish
Pages (from-to)17-23
JournalLung
Volume201
Issue number1
Early online date6 Feb 2023
DOIs
Publication statusPublished - Feb 2023

Keywords / Materials (for Non-textual outputs)

  • Asthma
  • Bronchiectasis
  • Exacerbations
  • Intravenous antibiotics

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