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Risk factors for bronchiectasis in patients with aspirin-exacerbated respiratory disease (AERD) include older age as well as the presence of allergic bronchopulmonary aspergillosis (ABPA), aspiration, mycobacterial infection, and pneumonia, according to a study in Journal of Allergy and Clinical Immunology: In Practice.
In this nested case-control study, researchers from Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, performed a retrospective chart review of patients with a diagnosis of AERD (N=742). A total of 149 patients had chest computed tomography (CT) imaging data and were reviewed for bronchiectasis. Markers of disease severity and known risk factors for bronchiectasis were compared between patients with AERD and bronchiectasis on chest CT (n=57) and patients with AERD without bronchiectasis on chest CT (n=92).
The mean age in the bronchiectasis group was 65±1.8 years vs 60±15 years in the non-bronchiectasis control group (P =.03). Patients with bronchiectasis had a significantly longer mean duration of AERD vs the individuals in the control group (26.5±2.5 vs 18.5±1.4, respectively; P =.004). Additionally, patients with bronchiectasis had a significantly lower mean forced expiratory volume in 1 second percent predicted value (67.1±2.7 vs 76.4±2.3; P =.01). Bronchiectasis was also associated with higher rates of physician-diagnosed ABPA (11% vs 0%; P =.001), aspiration (16% vs 7%; P =.03), mycobacterial infection (14% vs 1%; P =.001), and pneumonia (75% vs 54%; P =.02).
Limitations of this study included its retrospective design as well as the inclusion of a small number of participants with available CT imaging.
In response to the results of their study, the investigators wrote that the presence of the identified risk factors for bronchiectasis in patients with AERD “should prompt consideration of co-existing bronchiectasis and need for CT imaging, as patients with bronchiectasis may require more aggressive respiratory management.”
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Reference
Chen Y-C, Bensko J, Laidlaw TM, Buchheit KM. A retrospective analysis of bronchiectasis in patients with aspirin-exacerbated respiratory disease [published online April 21, 2020]. J Allergy Clin Immunol Pract. doi:10.1016/j.jaip.2020.04.017
