Pharmacotherapy for Non-Cystic Fibrosis Bronchiectasis: Results From an NTM Info & Research Patient Survey and the Bronchiectasis and NTM Research Registry.

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.

• Authors: Emily Henkle, Timothy R Aksamit, Alan F Barker, Jeffrey R Curtis, Charles L Daley, M Leigh Anne Daniels, Angela DiMango, Edward Eden, Kevin Fennelly, David E Griffith, Margaret Johnson, Michael R Knowles, Amy Leitman, Philip Leitman, Elisha Malanga, Mark L Metersky, Peadar G Noone, Anne E O'Donnell, Kenneth N Olivier, Delia Prieto, Matthias Salathe, Byron Thomashow, Gregory Tino, Gerard Turino, Susan Wisclenny, Kevin L Winthrop
• Journal: Chest (Chest) Vol. 152 Issue 6 Pg. 1120-1127 (12 2017) ISSN: 1931-3543 [Electronic] United States
• PMID: 28479113 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Intramural)
• Copyright: Copyright © 2017 American College of Chest Physicians. All rights reserved.

Chemical References

• Glucocorticoids
• Macrolides

Topics

• Administration, Inhalation
• Aged
• Biomedical Research
• Bronchi (microbiology, pathology)
• Bronchiectasis (drug therapy, epidemiology, etiology)
• Female
• Fibrosis
• Glucocorticoids (administration & dosage)
• Humans
• Incidence
• Macrolides (administration & dosage)
• Male
• Middle Aged
• Mycobacterium Infections, Nontuberculous (complications, drug therapy, microbiology)
• Nontuberculous Mycobacteria (isolation & purification)
• Registries
• Risk Assessment
• Self Report
• Surveys and Questionnaires
• United States (epidemiology)