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

Background: 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...

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Main Authors: Safia Ahmed, Sesha Sai Sutravey
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-11-01
Series:Journal of Advanced Lung Health
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Online Access:https://journals.lww.com/10.4103/jalh.jalh_9_24
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author Safia Ahmed
Sesha Sai Sutravey
author_facet Safia Ahmed
Sesha Sai Sutravey
author_sort Safia Ahmed
collection DOAJ
description Background: 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. Materials and Methods: 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. Results: 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. Conclusion: 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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spelling doaj-art-6cb7c9d8a92e4a629c8f82bdf05511502025-08-20T01:59:17ZengWolters Kluwer Medknow PublicationsJournal of Advanced Lung Health2772-71652772-71732024-11-015181410.4103/jalh.jalh_9_24Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot StudySafia AhmedSesha Sai SutraveyBackground: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.https://journals.lww.com/10.4103/jalh.jalh_9_24bronchial hyperresponsivenessbronchiectasisinhaled corticosteroids
spellingShingle Safia Ahmed
Sesha Sai Sutravey
Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot Study
Journal of Advanced Lung Health
bronchial hyperresponsiveness
bronchiectasis
inhaled corticosteroids
title Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot Study
title_full Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot Study
title_fullStr Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot Study
title_full_unstemmed Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot Study
title_short Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot Study
title_sort efficacy of inhaled corticosteroids in patients with bronchiectasis without airway hyperresponsiveness a pilot study
topic bronchial hyperresponsiveness
bronchiectasis
inhaled corticosteroids
url https://journals.lww.com/10.4103/jalh.jalh_9_24
work_keys_str_mv AT safiaahmed efficacyofinhaledcorticosteroidsinpatientswithbronchiectasiswithoutairwayhyperresponsivenessapilotstudy
AT seshasaisutravey efficacyofinhaledcorticosteroidsinpatientswithbronchiectasiswithoutairwayhyperresponsivenessapilotstudy