Clinical Heterogeneity in Bronchiectasis. Recommended Reading from the Singapore Respiratory Medicine Fellows

Phua, Chee Kiang; Chew, Sung Hock; Tan, Yi Hern; Tan, Ze Ying; Chotirmall, Sanjay H.

doi:10.1164/rccm.201901-0035rr

Cited by 1 publication

(1 citation statement)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In work by A liberti et al [77], 1145 NCFB patients recruited from across Europe illustrated four clinical NCFB phenotypes, as follows. 1) Chronic infection with PA, which had the most severe disease, worst radiological pattern and greatest inflammatory responses, including frequent exacerbations, hospitalisations and worst quality of life [78]. 2) Chronic infection with pathogens, with moderate levels of systemic inflammation and functional status and where 20% experienced at least an annual exacerbation.…”

Section: Are There Different Endophenotypes Of Patients With Ncfb?mentioning

confidence: 99%

Hot topics and current controversies in non-cystic fibrosis bronchiectasis

Severiche-Bueno

Gamboa

Chotirmall

2019

Breathe

Self Cite

View full text Add to dashboard Cite

Non-cystic fibrosis bronchiectasis (NCFB) is a neglected and orphan disease with poor advances through the 20th century. However, its prevalence is rising and with this come new challenges for physicians. Few guidelines are available to guide clinicians on how to diagnose and manage patients with NCFB. Many areas of debate persist, and there is lack of consensus about research priorities most needed to advance patient care and improve clinical outcomes. In this review, we highlight the current hot topics in NCFB and present updated evidence to inform the critical areas of controversy.Key pointsPostural drainage, active cycle of breathing techniques and pulmonary rehabilitation are non-pharmacological treatment options that should be offered to all patients with non-cystic fibrosis bronchiectasis (NCFB).Eradication of Pseudomonas aeruginosa (PA) colonisation in patients without an acute exacerbation remains debatable.Sputum cultures are the leading and most readily available tool to detect patients with chronic colonisation by PA and should be performed in all patients with NCFB.Antibacterial monoclonal antibodies and vaccine studies have shown promising results in the prevention of chronic colonisation with PA and should stimulate new studies in NCFB.NCFB patients colonised with PA are at more risk of a rapid decline in lung function, worsening quality of life and more hospital admissions.Dual therapy is a promising option for the management of patients with PA-related exacerbations.Patients with PA-related exacerbations benefit from prolonged courses of antibiotics (i.e. 14 days) but emerging and future studies, including dual therapy, may show promising results with shorter courses.Endophenotyping bronchiectasis to address its inherent heterogeneity is a promising avenue for future investment and research.

show abstract

Section: Are There Different Endophenotypes Of Patients With Ncfb?mentioning

confidence: 99%