Clinical features associated with a doctor-diagnosis of bronchiectasis in the Severe Asthma Network in Italy (SANI) registry. (4th March 2021)

• Record Type: Journal Article
• Authors: Malipiero, Giacomo; Paoletti, Giovanni; Blasi, Francesco; Paggiaro, Pierluigi; Senna, Gianenrico; Latorre, Manuela; Caminati, Marco; Carpagnano, Giovanna Elisiana; Crimi, Nunzio; Spanevello, Antonio; Aliberti, Stefano; Canonica, Giorgio Walter; Heffler, Enrico
• Is Part Of: Expert review of respiratory medicine. Volume 15:Number 3(2021)
• Page Start: 419
• Page End: 424
• Publication Date: 2021-03-04
• Subjects: Severe asthma -- registry -- bronchiectasis -- real-life -- phenotypes; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Treatment -- Periodicals; 616.2005
• DOI: 10.1080/17476348.2021.1840983
• Languages: English
• ISSNs: 1747-6348

Abstract

ABSTRACT: Background: Several severe asthma comorbidities have been identified: an emerging one is bronchiectasis. We evaluated the frequency of bronchiectasis on severe asthma in a real-life setting, through the 'Severe Asthma Network Italy' (SANI) registry. Methods: SANI registry encompasses demographic, clinical, functional and inflammatory data of Italian severe asthmatics. Data obtained by the enrolled patients were analyzed, focusing the attention on those patients with concomitant clinically relevant bronchiectasis. Results: About 15.5% patients have bronchiectasis. Bronchiectasis diagnosis was associated with a higher prevalence of chronic rhinosinusitis with nasal polyps (54.6% vs. 38%, p = 0.001) and higher serum IgE levels (673.4 vs. 412.1 kUI/L, p = 0.013). Patients with bronchiectasis had worse asthma control (ACT: 16.7 vs 18.2, p = 0.013), worse quality of life (AQLQ: 4.08 vs. 4.60, p = 0.02) and lower lung function (FEV1 % predicted 67.3 vs. 75.0, p = 0.002). A higher rate of severe asthma exacerbations in the previous 12 months (85.2% vs. 61.5%, p < 0.001) was found in patients with bronchiectasis. Conclusion: severe asthma associated with bronchiectasis represents a particularly severe asthma variant, possibly driven by an eosinophilic endotype. We, therefore, suggest that bronchiectasis should necessarily be assessed in severe asthmatic patients.