Late Breaking Abstract - Airway Hyperresponsiveness in Bronchiectasis

Background: It is not clear how many patients with bronchiectasis without a history of asthma or COPD have actual airway hyperresponsiveness (AHR) and would benefit from inhaled corticosteroids (ICS). The aim of this study is to assess the presence of AHR in non-CF bronchiectasis excluding patients with a history of asthma or COPD. Design: For this study we used the data from the screening of the FORZA study. The FORZA study is a prospective double-blind randomized controlled trial comparing formoterol-beclomethasone versus placebo to evaluate the reduction in cough in patients with non-CF bronchiectasis without an underlying disease of asthma or COPD. Patients with a known history of asthma or COPD were excluded. Patients already on ICS, but without a history of asthma or COPD, had to withdraw the ICS. We defined AHR as a positive bronchodilator responsiveness (ΔFEV1 of >12% and >200ml), a positive bronchial provocation test (<32 mg/ml; 0.5 min inhalation method) or as an increase in pulmonary complaints after withdrawing ICS during wash-out period. Results: Until now, we have preliminary data on the initial screening of 23 patients, of which 8 patients (35%) showed AHR. A positive bronchial provocation test was found in 2 patients. Furthermore, 3 patients showed a significant bronchodilator response. Finally, 3 patients experienced increased pulmonary complaints after ICS withdrawal. Since recruitment is ongoing, further screening results will be available soon. Conclusion: Preliminary data showed a surprisingly high percentage of AHR in non-CF bronchiectasis, excluding patients with a history of asthma or COPD. This raises the question if we should screen for AHR in all patients with non-CF bronchiectasis in clinical practice.