Bronchiectasis in COPD patients

Arram, Eman O.; Elrakhawy, Mohamed M.

doi:10.1016/j.ejcdt.2012.07.001

Cited by 22 publications

(28 citation statements)

References 31 publications

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“…A third of our study population was obese. Half had radiographic bronchiectasis, consistent with the reported prevalence of bronchiectasis in patients with COPD [ 33 ]. Five (36%) had IgG levels below 5 gm/L (one with monoclonal gammopathy), and these patients were not screened for vaccine hyporesponsiveness prior to Ig treatment to distinguish primary or secondary immunodeficiency from COPD- and treatment-associated hypogammaglobulinemia [ 23 , 24 ].…”

Section: Discussionsupporting

confidence: 79%

A Retrospective Longitudinal Within-Subject Risk Interval Analysis of Immunoglobulin Treatment for Recurrent Acute Exacerbation of Chronic Obstructive Pulmonary Disease

et al. 2015

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BackgroundRecurrent acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common, debilitating, costly and often difficult to prevent.MethodsWe reviewed records of patients who had COPD and immunoglobulin (Ig) treatment as adjunctive preventative treatment for AECOPD, and documented all AECOPD episodes for one year before and after initiation of Ig treatment. We graded AECOPD episodes as moderate for prescription of antibiotics and/or corticosteroids or for visit to the Emergency Department, and as severe for hospital admission. We conducted a retrospective within-subject self-controlled risk interval analysis to compare the outcome of annual AECOPD rate before and after treatment.ResultsWe identified 22 cases of certain COPD, of which three had early discontinuation of Ig treatment due to rash and local swelling to subcutaneous Ig, and five had incomplete records leaving 14 cases for analyses. The median baseline IgG level was 5.9 g/L (interquartile range 4.1–7.4). Eight had CT radiographic bronchiectasis. Overall, the incidence of AECOPD was consistently and significantly reduced in frequency from mean 4.7 (± 3.1) per patient-year before, to 0.6 (± 1.0) after the Ig treatment (p = 0.0001). There were twelve episodes of severe AECOPD (in seven cases) in the year prior, and one in the year after Ig treatment initiation (p = 0.016).ConclusionsIg treatment appears to decrease the frequency of moderate and severe recurrent AECOPD. A prospective, controlled evaluation of adjunctive Ig treatment to standard therapy of recurrent AECOPD is warranted.

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Section: Discussionsupporting

confidence: 79%

A Retrospective Longitudinal Within-Subject Risk Interval Analysis of Immunoglobulin Treatment for Recurrent Acute Exacerbation of Chronic Obstructive Pulmonary Disease

et al. 2015

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“…A total of 14 studies met the inclusion criteria, including 5329 COPD patients, and1572 (29.5%) patients were comorbid with bronchiectasis. Association of the presence of bronchiectasis with COPD exacerbations (ECOPD) [9][10][11][12]18,19,20]was reported in seven studies, isolation of PPMs [9,10,12,21,22]and specifically of Pseudomonas aeruginosa (P. aeruginosa) [9,10,23,24]in five and four studies respectively, severe airflow obstruction [9,11,12,18,19,25,26] in seven studies, mortality in four studies [10,19,23,27], and higher levels of inflammatory cytokines in three studies [10,11,21]which were not enough to conduct a metaanalysis.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Several studies [9][10][11] have revealed an association between bronchiectasis and COPD, reporting that the presence of bronchiectasis in patients with COPD is associated with increased bronchial inflammation, frequent colonization of airway by potentially pathogenic microorganisms (PPMs) and severe airflow obstruction. However, another observational study [12] suggests that the number of exacerbations and bacterial colonization are not related to bronchiectasis in COPD patients.…”

Section: Introductionmentioning

confidence: 99%

Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis

Jin

Liu

2016

Chest

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“…If we accept the broad definition of bronchiectasis as abnormal bronchial dilatations, then there are no reliable data on its prevalence in patients with COPD. Depending on the methodology used in the various studies to date, the reported prevalence ranges from 2 to 72% [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] . Table 1 shows some of the common causes of an under-or overestimation of the presence of bronchiectasis in patients with COPD.…”

Section: Bronchiectasis In Patients With Copd Prevalencementioning

confidence: 99%

“…There has only been one study analysing the impact of bronchiectasis on the quality of life Finally, one of the most consistently evident factors is the propensity of patients with bronchiectasis-associated COPD to have not only more exacerbations [14][15][16][17] but also ones that are more severe 13,15,17,20 and longer-lasting 9 , although not all authors have found this association 18,19,24 . Taken together, however, both the meta-analyses 28,29 found a relationship between exacerbations and bronchiectasis ( Table 3).…”

Section: Prognostic Impact Of Bronchiectasismentioning

confidence: 99%

Bronchiectasis in Chronic Obstructive Airway Disease: More than a Comorbidity?

Martínez‐García¹,

Ferrer²,

Olmeda³

2017

BRN

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Beyond the bronchial dilatations associated with age, several studies have documented a higher prevalence of bronchiectasis in patients with severe asthma or chronic obstructive pulmonary disease (COPD). Perhaps COPD or asthmatic patients with bronchiectasis represent a clinical phenotype characterised by greater clinical and functional severity, a higher number of exacerbations and, in the case of COPD, greater colonisation by potentially pathogenic microorganisms and probably a poor prognosis. Although international guidelines recommend that the two diseases are treated separately when they coexist, patients with COPD or asthma associated with bronchiectasis may benefit from specific treatments, such as long-term antibiotics, physiotherapy or macrolides. It is biologically plausible that severe asthma, and especially severe COPD, are related to de novo bronchiectasis, but no study has yet demonstrated any cause-effect relationship. Early diagnosis and treatment of bronchiectasis in COPD and asthma could be crucial to improve their prognosis. This relationship poses an interesting scientific challenge for the future. (BRN Rev. 2017;3:178-91)

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Bronchiectasis in COPD patients

Cited by 22 publications

References 31 publications

A Retrospective Longitudinal Within-Subject Risk Interval Analysis of Immunoglobulin Treatment for Recurrent Acute Exacerbation of Chronic Obstructive Pulmonary Disease

A Retrospective Longitudinal Within-Subject Risk Interval Analysis of Immunoglobulin Treatment for Recurrent Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis

Bronchiectasis in Chronic Obstructive Airway Disease: More than a Comorbidity?

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