Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot Study

Journal of Advanced Lung Health Pub Date : 2024-06-11 DOI:10.4103/jalh.jalh_9_24

Safia Ahmed, S. Sutravey

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Abstract

ABSTRACT The effect of inhaled corticosteroids (ICS) in stable cases of bronchiectasis without hyperresponsiveness has not been studied. The objective of the study was to assess the effect of inhaled fluticasone 500 μg twice daily on health-related quality of life (HRQoL), pulmonary function, and frequency of exacerbations in stable patients of bronchiectasis without bronchial hyperresponsiveness (BHR) diagnosed by indirect bronchoprovocation test. It was a pilot study with an open-label randomized control design conducted in a Tertiary Care Chest Hospital, with 40 patients in each arm. Bronchiectasis was diagnosed by high-resolution computed tomography chest. Patients with BHR were excluded by performing an indirect bronchoprovocation test using inhaled adenosine monophosphate. Eighty patients meeting the inclusion criteria were randomized into intervention group (IG) receiving 500 μg fluticasone propionate twice a day and control group (CG) receiving standard care without ICS. Both groups were assessed monthly till 6 months. Clinical data (mainly forced expiratory volume in 1st s [FEV1], number of exacerbations, HRQoL by St. George respiratory questionnaire (SGRQ) was collected at baseline and end of 6 months. Eighty (IG - 40, CG - 40) patients of stable state noncystic fibrosis bronchiectasis completed the study. The mean age in our study was IG 49.7 ± 17.6 vs. CG 49.9 ± 16.6, males IG 62.5% vs. CG 60%, most common etiology was tuberculosis IG 40% (16/40) vs CG 37.5% (15/40). Difference in SGRQ score (baseline end of treatment) IG 5.47 vs. CG 1.65 (p = 0.00). Difference in FEV1 IG 0.054L vs. CG 0.004L (P = 0.00), mean number of exacerbations at end of treatment IG – 1 ± 0.9 vs. CG 1.2 ± 1.1. Patients with stable bronchiectasis without BHR, treated with inhaled fluticasone 500 μg twice daily for 6 months showed a clinically significant improvement in HRQoL. No statistically significant difference was seen in pulmonary function and frequency of exacerbations.

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吸入皮质类固醇对无气道高反应性的支气管扩张症患者的疗效：试点研究

摘要吸入性皮质类固醇（ICS）对无高反应性的稳定型支气管扩张病例的影响尚未得到研究。本研究的目的是评估吸入氟替卡松 500 μg，每天两次，对通过间接支气管定位试验诊断为无支气管高反应性（BHR）的稳定型支气管扩张症患者的健康相关生活质量（HRQoL）、肺功能和恶化频率的影响。这是一项试验性研究，采用开放标签随机对照设计，在一家三级甲等胸科医院进行，每组 40 名患者。支气管扩张症通过高分辨率胸部计算机断层扫描进行诊断。通过吸入单磷酸腺苷进行间接支气管扩张试验，排除支气管扩张症患者。符合纳入标准的 80 名患者被随机分为干预组（IG）和对照组（CG），干预组接受 500 μg 丙酸氟替卡松，每天两次，对照组接受标准护理，不使用 ICS。两组均每月进行一次评估，直至 6 个月。在基线和 6 个月结束时收集临床数据（主要是 1 秒用力呼气容积[FEV1]、病情加重次数、圣乔治呼吸系统问卷调查（SGRQ）的 HRQoL）。 80名（IG - 40，CG - 40）稳定状态非囊性纤维化支气管扩张症患者完成了研究。我们研究的平均年龄为（49.7 ± 17.6）岁（IG 49.9 ± 16.6）岁（CG 49.9 ± 16.6）岁，男性（IG 62.5% vs. CG 60%），最常见的病因是肺结核（IG 40% (16/40) vs. CG 37.5% (15/40)）。SGRQ 评分差异（基线治疗结束时）IG 5.47 vs. CG 1.65（p = 0.00）。FEV1 IG 0.054L vs. CG 0.004L (P = 0.00)，治疗结束时的平均恶化次数 IG - 1 ± 0.9 vs. CG 1.2 ± 1.1。吸入氟替卡松 500 μg，每天两次，连续治疗 6 个月，无 BHR 的稳定型支气管扩张症患者的 HRQoL 有显著改善。肺功能和病情恶化频率方面的差异无统计学意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of Advanced Lung Health

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