Pharmacotherapy for non-cystic fibrosis bronchiectasis: results from an NTM Info & Research patient survey and the Bronchiectasis and NTM Research Registry

Purpose

Non-cystic fibrosis bronchiectasis ("bronchiectasis") is a chronic inflammatory lung disease often associated with nontuberculous mycobacterium (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 U.S.

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 U.S. Bronchiectasis and NTM Research Registry (BRR).

Results

Among 511 NTMir survey responders with bronchiectasis, median age was 67, 85 (17%) reported asthma, and 99 (19%) reported chronic obstructive pulmonary disease (COPD). History of ICS use was reported by 282 (55%), of whom 171 (61%) were treated >1 year and 150 (53%) were currently taking ICS. Fewer reported ever taking azithromycin for non-NTM bronchiectasis (203, 40%) or inhaled tobramycin (78, 15%). Median age of 1912 BRR patients was 69, 528 (28%) had asthma, and 360 (19%) had COPD. Among 740 lacking NTM, 314 (42%) were taking ICS at baseline. Among non-NTM patients taking ICS, only 178 (57%) had a concurrent diagnosis of COPD or asthma that could explain ICS use. Fewer were taking suppressive macrolides (96, 13%) and of the 70 (10%) taking inhaled suppressive antibiotics, 48 (68%) had chronic Pseudomonas aeruginosa infection.

Conclusions

In two national samples of bronchiectasis patients ICS use is common, with relatively few patients taking suppressive antibiotic therapies. Further research is needed to clarify the safety and effectiveness of these therapies in bronchiectasis patients.

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