Browse by author
Lookup NU author(s): Professor Anthony De SoyzaORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© Author(s) (or their employer(s)) 2025.Introduction: Current bronchiectasis guidelines advise against the use of inhaled corticosteroids (ICS) except in patients with associated asthma, allergic bronchopulmonary aspergillosis (ABPA) and/or chronic obstructive pulmonary disease (COPD). This study aimed to describe the use of ICS in patients with bronchiectasis across Europe. Methods: Patients with bronchiectasis were enrolled into the European Bronchiectasis Registry from 2015 to 2022. Patients were grouped into ICS users and non-users at baseline and clinical characteristics associated with ICS use were investigated. Patients were followed up for clinical outcomes of exacerbation, hospitalisation and mortality for up to 5 years. We evaluated if elevated blood eosinophil counts (above the laboratory upper limit of normal) modified the effect of ICS on exacerbations. Results: 19 324 patients were included for analysis and 10 109 (52.3%) were recorded as being prescribed ICS at baseline. After exclusion of patients with a history of asthma, COPD and/or ABPA, 3174/9715 (32.7%) patients with bronchiectasis were prescribed ICS. Frequency of ICS use varied across countries, ranging from 17% to 85% of included patients. ICS users had more severe disease, with significantly worse lung function, higher Bronchiectasis Severity Index scores and more frequent exacerbations at baseline (p<0.0001). Overall, ICS users did not have a reduced risk of exacerbation or hospitalisation during follow-up, but a significant reduction in exacerbation frequency was observed in the subgroup of ICS users with elevated blood eosinophil counts (relative risk 0.70, 95% CI 0.59 to 0.84, p<0.001). Conclusion: ICS use is common in bronchiectasis, including in those not currently recommended ICS according to bronchiectasis guidelines. ICS use may be associated with reduced exacerbation frequency in patients with elevated blood eosinophils.
Author(s): Pollock J, Polverino E, Dhar R, Dimakou K, Traversi L, Bossios A, Haworth C, Loebinger MR, De Soyza A, Vendrell M, Burgel PR, Mertsch P, McDonnell MJ, Skgrat S, Maiz-Carro L, Sibila O, Van Der Eerden M, Kauppi P, Hill AT, Wilson R, Milenkovic B, Menendez R, Murris M, Crichton ML, Borecki S, Obradovic D, Irfan M, Eshenkulova V, Nowinski A, Amorim A, Torres A, Lorent N, Welte T, Blasi F, Van Braeckel E, Altenburg J, Shteinberg M, Boersma W, Elborn JS, Aliberti S, Ringshausen FC, Goeminne P, Chalmers JD
Publication type: Article
Publication status: Published
Journal: Thorax
Year: 2025
Pages: epub ahead of print
Online publication date: 23/03/2025
Acceptance date: 23/01/2025
Date deposited: 15/04/2025
ISSN (print): 0040-6376
ISSN (electronic): 1468-3296
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/thorax-2024-221825
DOI: 10.1136/thorax-2024-221825
Data Access Statement: Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.
Altmetrics provided by Altmetric
