Researchers have created a new scoring tool based on the identification of several factors that can predict bronchiectasis in patients with uncontrolled asthma, according to a recent study.
In particular, they found that severity of asthma, the presence of chronic expectoration, previous episodes of pneumonia, and lower levels of fractional exhaled nitric oxide (FeNO) can be independent predictive factors of bronchiectasis in patients with uncontrolled moderate-to-severe asthma (USMA).
Based on these four variables — FeNO, Pneumonia, Expectoration and asthma Severity — researchers proposed the NOPES scoring system, an easy, predictive tool for bronchiectasis in these patients.
“The NOPES score is an easy-to-use scoring system with a high prognostic value for bronchiectasis in patients with uncontrolled moderate-to-severe asthma,” the researchers wrote.
Findings were published in the study, “Factors associated with bronchiectasis in patients with uncontrolled asthma; the NOPES score: a study in 398 patients,” in the journal Respiratory Research.
Bronchiectasis, a disease characterized by the permanent enlargement of the airways, is frequently associated with asthma, a chronic inflammation of the pulmonary airways. Bronchiectasis in asthma patients can redefine both the prognosis and therapeutic approach, but studies on both diseases are limited.
Researchers investigated the prevalence of bronchiectasis in nonsmokers with UMSA in this prospective study using the largest sample ever reported. They also tried to identify factors associated with the presence of bronchiectasis in these patients.
A total of 398 patients with UMSA were included in the study. The diagnosis of bronchiectasis was based on high-resolution computed tomography. The potential factors associated with bronchiectasis were determined using a prognostic score based on asthma severity, presence of chronic expectoration, previous episodes of pneumonia and FeNO levels — the NOPES score.
Of the 398 patients enrolled, 40.2 % had moderate asthma, while 59.8% had severe asthma. In total, 20.6% of the patients with moderate asthma were diagnosed with bronchiectasis, while the prevalence was higher in patients with severe asthma (33.6%).
Of the several variables studied, bronchiectasis was associated with four in particular: a higher frequency of chronic expectoration, greater asthma severity, at least one previous episode of pneumonia, and lower levels of nitric oxide in exhaled air (less than 20.5 parts per billion), leading to the development of the NOPES scoring system.
“The likelihood of bronchiectasis rises as the NOPES score increases (according to the presence or absence of the four variables proposed). Low scores indicate the absence of bronchiectasis, whereas high scores suggest its presence,” the team concluded.