Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

Aliberti, Stefano; Masefield, Sarah; Polverino, Eva; Soyza, Anthony De; Loebinger, Michael R.; Menéndez, Rosário; Ringshausen, Felix C.; Vendrell, Montserrat; Powell, Pippa; Chalmers, James D.

doi:10.1183/13993003.01888-2015

Cited by 181 publications

(158 citation statements)

References 72 publications

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“…The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) recently outlined several research priorities for improving the management of bronchiectasis [14, 15], including greater understanding of its classification and prognosis. Since there is a tendency to manage bronchiectasis based on approaches used for chronic obstructive pulmonary disease (COPD) and cystic fibrosis [16, 17], FEV 1 has traditionally been used to define the severity of bronchiectasis.…”

Section: Discussionmentioning

confidence: 99%

Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts

Athanazio

Pereira

Gramblicka³

et al. 2017

BMC Pulm Med

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BackgroundThe FACED score is an easy-to-use multidimensional grading system that has demonstrated an excellent prognostic value for mortality in patients with bronchiectasis. A Spanish group developed the score but no multicenter international validation has yet been published.MethodsRetrospective and multicenter study conducted in six historical cohorts of patients from Latin America including 651 patients with bronchiectasis. Clinical, microbiological, functional, and radiological variables were collected, following the same criteria used in the original FACED score study. The vital status of all patients was determined in the fifth year of follow-up. The area under ROC curve (AUC-ROC) was used to calculate the predictive power of the FACED score for all-cause and respiratory deaths and both number and severity of exacerbations. The discriminatory power to divide patients into three groups of increasing severity was also analyzed.ResultsMean (SD) age of 48.2 (16), 32.9% of males. The mean FACED score was 2.35 (1.68). During the follow up, 95 patients (14.6%) died (66% from respiratory causes). The AUC ROC to predict all-cause and respiratory mortality were 0.81 (95% CI: 0.77 to 0.85) 0.84 (95% CI: 0.80 to 0.88) respectively, and 0.82 (95% CI: 078–0.87) for at least one hospitalization per year. The division into three score groups separated bronchiectasis into distinct mortality groups (mild: 3.7%; moderate: 20.7% and severe: 48.5% mortality; p < 0.001).ConclusionsThe FACED score was confirmed as an excellent predictor of all-cause and respiratory mortality and severe exacerbations, as well as having excellent discriminative capacity for different degrees of severity in various bronchiectasis populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-017-0417-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts

Athanazio

Pereira

Gramblicka³

et al. 2017

BMC Pulm Med

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“…Thus, translating current evidence and recommendations for the general population with pNTM disease to a specific population of bronchiectasis patients might not be fully appropriate. In view of this scenario, specific evidence on NTM infection in bronchiectasis is needed to help physicians in identifying patients with pNTM disease and treating them appropriately [10]. …”

Section: Introductionmentioning

confidence: 99%

Characterizing Non-Tuberculous Mycobacteria Infection in Bronchiectasis

Faverio

Stainer

Bonaiti

et al. 2016

IJMS

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Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a “tree-in-bud” pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research.

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“…Additionally, the different populations in RESPIRE 1 and 2 yielded similar trends toward benefit from ciprofloxacin DPI therapy but probably with different mechanisms at work, including anti-microbial, anti-inflammatory and/or immunomodulatory effects. A clear challenge emerging from RESPIRE and other clinical therapeutic trials in bronchiectasis is the vast ethnic, geographic and endophenotypic heterogeneity of disease [8][9][10][11]. This makes trials in bronchiectasis challenging to perform, analyse and report accurately.…”

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confidence: 99%