Bronchiectasis in France: data on disease characteristics in 630 patients from the European Bronchiectasis registry (EMBARC)

Abstract

Background: Little is known about the characteristics of adults with bronchiectasis in France.

Methods: A descriptive cross-sectional study was conducted to describe the characteristics of adults (≥18 years) with clinically-significant bronchiectasis, diagnosed on a combination of respiratory symptoms and CT scan findings, and followed in 18 participating centers. Data on, etiology, lung function, symptoms, microbiology, treatments and quality of life were collected.

Results: Between January 2016 and July 2022, 630 adults (females: 66 %; ≥55 years: 73.8 %) were included. Idiopathic and post-infective causes represented 33.0 % and 37.1 % respectively; COPD and asthma, which were present in 15.6 % and 23.6 % of subjects, were considered as causes of bronchiectasis in only 3.8 % and 2.9 %, respectively. Only 25 % had normal spirometry and 7.3 % required long-term oxygen therapy. Daily sputum production was present in 78.1 % and 29.0 % had a modified Medical Research Council (mMRC) dyspnea score ≥2. Positive bacterial sputum culture was found in 77.8 % of those with sputum samples (n = 455); including 157 (34.5 %) positive for Pseudomonas aeruginosa within the past year. During the year prior to study entry, 75.4 % of patients reported at least one respiratory exacerbation, 33.8 % had at least one hospitalization and 24.5 % received outpatient parenteral antimicrobial therapy (OPAT). Using the bronchiectasis severity index 26.0 %, 36.4 % and 37.6 % were considered as having mild, moderate and severe disease, respectively.

Conclusion: In France, adults with bronchiectasis experience significant disease burden. Respiratory exacerbations are responsible for healthcare utilization and their prevention may require specialized multidisciplinary care and the development of novel therapeutic interventions.

Keywords: Bronchiectasis; Pseudomonas aeruginosa; vaccine.