Exacerbation Prevention: Research Highlights Unmet Need in Bronchiectasis Treatment

Timothy Aksamit, MD

New data featured in a poster presentation at NORD Breakthrough Summit 2022 supported the need for exacerbation prevention among patients with bronchiectasis, a rare chronic condition. Investigators emphasized this as an important unmet need that requires intervention.

A total of 520 patients were separated into 3 groups according to the number of bronchiectasis exacerbations. Findings showed that patients with 2 or more exacerbations present at baseline had the greatest number of exacerbations 2 and 4 years later, as compared with patients who had no exacerbations, or a single exacerbation.

Timothy Aksamit, MD, Louisiana State University Health Sciences Center, New Orleans, and investigators explored the association between the number of initial exacerbations and the presence of exacerbation frequency over the span of 4 years. Patients with the chronic respiratory disease have permanently dilated bronchi often accompanied by persistent cough and sputum production.

Exacerbations are the periodic worsening of disease symptoms that can be triggered by bacterial or viral infections. Evidence has indicated that in addition to the typical symptoms, bronchiectasis exacerbations can reduce an individual's quality of life and lung function, while increasing their likelihood of hospitalization and mortality.

These episodes are important events in the natural history of bronchiectasis and understanding the impact they have on patients can facilitate more focus on prevention and better interventions, according to investigators. The analyses performed on the 3 study groups represented various relationships.

When looking at age, bronchiectasis duration, nontuberculous mycobacteria and P. aeruginosa status, FEV, and asthma, investigators observed significant differences across the groups. Younger patients were more likely to have a higher number of exacerbations (2 or more), while older patients presented with little to none.

Alternatively, the smoking status of the patient and BMI were consistent when comparing the study groups.

When analyzing the groups’ relationship at each study interval (baseline, 2 years, and 4 years), results revealed a statistically significant correlation with the amount of exacerbations. A higher number of exacerbations at baseline was positively associated with a higher number at each follow up point.

Some limitations noted were that patient enrollment was facilitated by their physicians and therefore a possibility of reporting bias should be taken into account. Because this research was conducted in the US, these results may not give a complete representation of the bronchiectasis patient population outside of the country since the data were gathered from tertiary referral centers with a bronchiectasis interest.