Rheumatic diseases as well as
inflammatory bowel disease (IBD) have been associated with the occurrence of non-
cystic fibrosis bronchiectasis (NCFB). There are few data on NCFB and adverse events from immunosuppressive or
biological response modifier therapy in patients with
rheumatoid arthritis (RA) or IBD and NCFB. We identified 37 patients with NCFB and
rheumatic disease, and nine patients with
inflammatory bowel disease that received immunomodulatory treatment. We retrospectively analysed adverse pulmonary events. In nine patients with RA, the association between disease activity score (
DAS) and spirometry was analysed in a small cohort study. Pulmonary side effects occurred in 50% of patients, most commonly
respiratory infections, and resulted in a change of immunomodulatory treatment in 37% of patients. Spirometry and exacerbation rate was not different in NCFB patients with RA or IBD as compared with NFCB due to other causes. The incidence of pulmonary adverse events was highest in patients treated with conventional immunomodulatory treatment, especially
methotrexate, as compared with patients with NCFB treated with newer
biological therapies. Three patients were started on
azithromycin because of recurrent
bronchitis and had no events afterwards. Serial assessment of
DAS and spirometry showed that a rise in
DAS was associated with lung function decline and vice versa. Currently used immunosuppressive drugs can be used in NCFB albeit under close follow-up. The role of
azithromycin for
infection prevention needs further research. An association between
DAS and lung function was shown.