In a randomized controlled trial, published in Lung, researchers presented findings from a post hoc analysis of a randomized controlled trial on the impact of asthma in patients with bronchiectasis undergoing antibiotic treatment for exacerbations.
Patients with bronchiectasis and asthma and those without asthma had very similar responses to intravenous antibiotics; however, investigators found that patients with asthma had an increased risk of relapse within 14 days of completing antibiotics.
Asthmatics Relapse Earlier After Bronchiectasis Exacerbation Treatment
According to the authors, none of the patients with asthma required oral steroids at the start of the exacerbation or throughout up to 14 days of therapy, supporting a primary diagnosis of exacerbation of bronchiectasis infection and not exacerbation of asthma.
The researchers assessed 38 patients with bronchiectasis and comorbid asthma and 34 patients with bronchiectasis without asthma. Both groups had comparable age, sex, and bronchiectasis severity, as well as comparable outcomes in all of the study’s end points.
Patients with asthma had a higher rate of early relapse by day 14 compared to patients without asthma, at 31.6% versus 11.8%, respectively (P=.03). Investigators wrote that asthma was the only independent risk factor for relapse by day 14 in their analysis (hazard ratio, 3.16; 95% CI, 1.02-9.79; P=.047).
The article added the analysis was limited by its post hoc nature, noting the original investigators did not assign asthma diagnoses and they were determined via clinical parameters. Additionally, the original study did not include any assessment of subsequent exacerbation relapses.
Overall, the authors frequently identified comorbid asthma in patients with bronchiectasis exacerbation who received intravenous antibiotic therapy, and they suggested comorbid patients showed a higher risk of 14-day early relapse after completing treatment.]
“Randomised control trials are needed to explore whether patients with bronchiectasis and coexisting asthma would benefit with adjunctive systemic steroids with intravenous antibiotics,” the report concluded.
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