Asthma is commonly reported in patients with a diagnosis of bronchiectasis. The aim of this study was to evaluate if patients with asthma and bronchiectasis had a different clinical phenotype and different outcomes compared to patients with bronchiectasis without concomitant asthma. Prospective observational pan-European registry (EMBARC) enrolling patients across 28 countries. Adult patients with CT confirmed bronchiectasis were reviewed at baseline and annual follow-up visits using an electronic case report form. Asthma was diagnosed by the local investigator. Follow-up data were used to explore differences in exacerbation frequency between groups using a negative binomial regression model. Survival analysis utilised Cox-proportional hazards regression. 16963 patients with bronchiectasis were included for analysis. 5267 patients (31.0%) had investigator reported asthma. Patients with bronchiectasis and asthma (BE+A) were younger, more likely to be female and never smokers, and had a higher BMI than patients with bronchiectasis without asthma. BE+A was associated with a higher prevalence of rhinosinusitis and nasal polyps as well as eosinophilia and sensitization. BE+A had similar microbiology, but significantly lower severity of disease using the bronchiectasis severity index (BSI). The BE+A group were at increased risk of exacerbation after adjustment for severity of disease and multiple confounders. Inhaled corticosteroid use was associated with reduced mortality in BE+A patients (adjusted hazard ratio 0.78 (0.63-0.95)) and reduced risk of hospitalization, (rate ratio 0.67 (0.67-0.86)) compared to a control population without asthma and not receiving inhaled corticosteroid. Combined bronchiectasis and asthma was common and was associated with an increased risk of exacerbations and improved outcomes with inhaled corticosteroid use. Unexpectedly we identified significantly lower mortality in patients with bronchiectasis and asthma.

中文翻译：

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支气管扩张和哮喘：数据来自欧洲支气管扩张登记处 (EMBARC)

哮喘常见于诊断为支气管扩张的患者。本研究的目的是评估患有哮喘和支气管扩张的患者与不伴有哮喘的支气管扩张患者相比是否具有不同的临床表型和不同的结果。前瞻性观察性泛欧注册中心 (EMBARC) 在 28 个国家/地区招募患者。使用电子病例报告表对 CT 证实患有支气管扩张的成年患者进行基线和年度随访检查。当地调查员诊断出哮喘。随访数据用于使用负二项回归模型探讨组间恶化频率的差异。生存分析利用 Cox 比例风险回归。纳入了 16963 名支气管扩张患者进行分析。5267 名患者 (31.0%) 患有研究者报告的哮喘。与患有支气管扩张但不患有哮喘的患者相比，患有支气管扩张和哮喘 (BE+A) 的患者更年轻，更有可能是女性且从不吸烟，并且体重指数更高。BE+A 与鼻窦炎和鼻息肉以及嗜酸性粒细胞增多和过敏的较高患病率相关。BE+A 具有相似的微生物学特征，但使用支气管扩张严重程度指数 (BSI) 得出的疾病严重程度明显较低。在调整疾病严重程度和多种混杂因素后，BE+A 组的病情恶化风险增加。与没有哮喘且未接受治疗的对照人群相比，吸入皮质类固醇的使用与 BE+A 患者死亡率降低（调整后风险比 0.78（0.63-0.95））和住院风险降低（比率 0.67（0.67-0.86））相关。吸入皮质类固醇。支气管扩张和哮喘合并症很常见，并且与吸入皮质类固醇使用增加的病情加重风险和改善的结局相关。出乎意料的是，我们发现支气管扩张和哮喘患者的死亡率显着降低。