Prescription of Inhaled corticosteroid in non-cystic fibrosis bronchiectasis:a solution or a problem

Abstract

Introduction: The use of inhaled corticosteroids (ICS) would be potentially effective in reducing symptoms and the number of exacerbations in non-cystic fibrosis (N-CF) bronchiectasis.

Aims: To evaluate the efficacy and safety of ICS in adults with N-CF bronchiectasis.

Methods: Retrospective study including 125patients with N-CF bronchiectasis in stable condition. These patients were divided in two groups: the first group (G1) consists of 70 patients who received ICS and the second group (G2) consists of 55 patients who did not receive ICS.

Results: We recruited 125 patients in this study. In the G1, the number of patients hospitalized for acute exacerbation and the number of hospitalizations in the intensive care unit were higher (p <0.05). Also, the number of re-hospitalization in the year following the prescription of ICS was significantly higher in G1(p=0.013). In fact, the average hospitalization rate increased from 0.7 ± 1.04 to 1.34 ±1.66 after ICS therapy. Respiratory function was clearly improved after ICS therapy, in fact the mean FEV increased from 1.38 to 4.62 l/min. The bacteriological investigation revealed a bronchial infection with Pseudomonas Aeroginosa in 8 patients undergoing inhaled corticosteroid therapy, whereas it was only 2 patients in G2 but without a statistically significant difference. The biological inflammatory syndrome was more evident in the G1 (p >0.05).In G1, fifteen patients (21.4%) received oxygen therapy and / or non-invasive ventilation at home versus one patient in G2 (p = 0.17).The number of deaths was greater in the G1 (p = 0.17).

Conclusion: ICS can contribute to the improvement of lung function in patientswithnonN-CF bronchiectasis. This benefit remains controversial despite the presence of chronic airway inflammation