CHEST COPD Immersion June 2025-7. Bronchiectasis Overlap

7. Bronchiectasis Overlap_COPD and Asthma

Pdf Summary

The document is a comprehensive presentation by Dr. Anne O'Donnell, covering an update on bronchiectasis as of 2025. The overview includes the epidemiology, etiologies, and treatment plans for bronchiectasis, highlighting the complexities and multifaceted nature of managing the disease.<br /><br />Epidemiologically, bronchiectasis affects between 340,000 and 522,000 people in the U.S., with a higher prevalence in women and older adults. The condition is notably more common among Asian Americans. The presentation underscores an increasing incidence and prevalence, particularly revealed during low-dose CT screenings for lung cancer.<br /><br />Clinically, bronchiectasis involves permanent airway dilatation and is diagnosed using imaging like high-resolution CT scans, pulmonary function tests, and respiratory cultures.<br /><br />Treatment strategies revolve around addressing underlying causes, airway clearance, the use of anti-inflammatories, and antibiotics, with new therapeutics on the horizon. Traditional treatments include physical therapies such as chest physiotherapy and nebulized treatments like hypertonic saline. Antibiotic therapy, particularly inhaled options, remains critical for managing infections like Pseudomonas aeruginosa.<br /><br />The summary indicates that bronchiectasis often overlaps with conditions like COPD and asthma, complicating the management. A notable portion of COPD patients display bronchiectatic characteristics, while a significant cohort of bronchiectasis patients also report asthma, mainly younger, non-smoking females with frequent sinusitis and nasal polyposis.<br /><br />Reducing exacerbations is a primary treatment goal, focusing on maintaining lung function and quality of life, and preventing hospitalizations. Bacterial load and managing key pathogens also play crucial roles, with anti-inflammatory therapies and targeting infections as emerging areas.<br /><br />New treatments involve innovative avenues like pheromone therapies, targeting neutrophilic inflammation, potential roles for CFTR modulators, and personalized treatment strategies, emphasizing the need for educational improvements and patient self-management involvement. The document concludes with advocacy for earlier diagnoses, physician education, and repurposing therapies to improve patient outcomes.

Keywords

bronchiectasis

epidemiology

etiologies

treatment plans

airway clearance

antibiotics

Pseudomonas aeruginosa

COPD

Chronic Obstructive Pulmonary Disease

asthma

neutrophilic inflammation