Emily Henkle1, Timothy R Aksamit2, Alan F Barker3, Jeffrey R Curtis4, Charles L Daley5, M Leigh Anne Daniels6, Angela DiMango7, Edward Eden8, Kevin Fennelly9, David E Griffith10, Margaret Johnson11, Michael R Knowles6, Amy Leitman12, Philip Leitman12, Elisha Malanga13, Mark L Metersky14, Peadar G Noone6, Anne E O'Donnell15, Kenneth N Olivier9, Delia Prieto13, Matthias Salathe16, Byron Thomashow7, Gregory Tino17, Gerard Turino8, Susan Wisclenny12, Kevin L Winthrop18. 1. OHSU-PSU School of Public Health, Portland, OR. Electronic address: emhenkle@gmail.com. 2. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN. 3. Division of Pulmonology and Critical Care, Department of Medicine, Oregon Health & Science University, Portland, OR. 4. Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham AL. 5. Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO. 6. Department of Medicine and the Marsico Lung Institute, and UNC Center for Bronchiectasis Care, University of North Carolina at Chapel Hill, Chapel Hill, NC. 7. Center for Chest Disease, Columbia College of Physicians and Surgeons, New York, NY. 8. Icahn School of Medicine, Mt. Sinai, NY. 9. Pulmonary Clinical Medicine Section, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD. 10. Pulmonary Infectious Disease Section, University of Texas Health Science Center Northesast, Tyler, TX. 11. Division of Pulmonary and Critical Care Medicine, Mayo Clinic Florida, Jacksonville, FL. 12. NTM Info & Research, Coral Gables, FL. 13. COPD Foundation, Washington, DC. 14. Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington, CT. 15. Division of Pulmonary, Critical Care, and Sleep Medicine, Georgetown University Hospital, Washington, DC. 16. Division of Pulmonary and Critical Care Medicine, Miller School of Medicine, University of Miami, Miami, FL. 17. Department of Medicine, Penn Presbyterian Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 18. OHSU-PSU School of Public Health, Portland, OR; Division of Infectious Disease, Department of Medicine, Oregon Health & Science University, Portland, OR.
Abstract
BACKGROUND: Non-cystic fibrosis bronchiectasis ("bronchiectasis") is a chronic inflammatory lung disease often associated with nontuberculous mycobacteria (NTM) infection. Very little data exist to guide bronchiectasis management decisions. We sought to describe patterns of inhaled corticosteroid (ICS) and antibiotic therapy in the United States. METHODS: We invited 2,000 patients through NTM Info & Research (NTMir) to complete an anonymous electronic survey. We separately queried baseline clinical and laboratory data from the US Bronchiectasis and NTM Research Registry (BRR). RESULTS: Among 511 NTMir survey responders with bronchiectasis, whose median age was 67 years, 85 (17%) reported asthma and 99 (19%) reported COPD. History of ICS use was reported by 282 (55%), 171 (61%) of whom were treated 1 year or longer, and 150 (53%) were currently taking ICSs. Fewer reported ever taking azithromycin for non-NTM bronchiectasis (203 responders [40%]) or inhaled tobramycin (78 responders [15%]). The median age of 1,912 BRR patients was 69 years; 528 (28%) had asthma and 360 (19%) had COPD. Among 740 patients (42%) without NTM, 314 were taking ICSs at baseline. Among patients without NTM who were taking ICSs, only 178 (57%) had a concurrent diagnosis of COPD or asthma that could explain ICS use. Fewer were taking suppressive macrolides (96 patients [13%]), and of the 70 patients (10%) taking inhaled suppressive antibiotics, 48 (68%) had chronic Pseudomonas aeruginosa infection. CONCLUSIONS: ICS use was common in two national samples of patients with bronchiectasis, with relatively few patients taking suppressive antibiotic therapies. Further research is needed to clarify the safety and effectiveness of these therapies in patients with bronchiectasis.
BACKGROUND:Non-cystic fibrosis bronchiectasis ("bronchiectasis") is a chronic inflammatory lung disease often associated with nontuberculous mycobacteria (NTM) infection. Very little data exist to guide bronchiectasis management decisions. We sought to describe patterns of inhaled corticosteroid (ICS) and antibiotic therapy in the United States. METHODS: We invited 2,000 patients through NTM Info & Research (NTMir) to complete an anonymous electronic survey. We separately queried baseline clinical and laboratory data from the US Bronchiectasis and NTM Research Registry (BRR). RESULTS: Among 511 NTMir survey responders with bronchiectasis, whose median age was 67 years, 85 (17%) reported asthma and 99 (19%) reported COPD. History of ICS use was reported by 282 (55%), 171 (61%) of whom were treated 1 year or longer, and 150 (53%) were currently taking ICSs. Fewer reported ever taking azithromycin for non-NTM bronchiectasis (203 responders [40%]) or inhaled tobramycin (78 responders [15%]). The median age of 1,912 BRR patients was 69 years; 528 (28%) had asthma and 360 (19%) had COPD. Among 740 patients (42%) without NTM, 314 were taking ICSs at baseline. Among patients without NTM who were taking ICSs, only 178 (57%) had a concurrent diagnosis of COPD or asthma that could explain ICS use. Fewer were taking suppressive macrolides (96 patients [13%]), and of the 70 patients (10%) taking inhaled suppressive antibiotics, 48 (68%) had chronic Pseudomonas aeruginosa infection. CONCLUSIONS: ICS use was common in two national samples of patients with bronchiectasis, with relatively few patients taking suppressive antibiotic therapies. Further research is needed to clarify the safety and effectiveness of these therapies in patients with bronchiectasis.
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Authors: Michal Shteinberg; Barbara Crossley; Tal Lavie; Sima Nadler; Jeanette Boyd; Felix C Ringshausen; Tim Aksamit; James D Chalmers; Pieter Goeminne Journal: ERJ Open Res Date: 2019-10-30
Authors: Katherine A Despotes; Radmila Choate; Doreen Addrizzo-Harris; Timothy R Aksamit; Alan Barker; Ashwin Basavaraj; Charles L Daley; Edward Eden; Angela DiMango; Kevin Fennelly; Julie Philley; Margaret M Johnson; Pamela J McShane; Mark L Metersky; Anne E O'Donnell; Kenneth N Olivier; Matthias A Salathe; Andreas Schmid; Byron Thomashow; Gregory Tino; Kevin L Winthrop; Michael R Knowles; Mary Leigh Anne Daniels; Peadar G Noone Journal: Chronic Obstr Pulm Dis Date: 2020-10