Posts by: Alexandra Andersson, PhD

Bronchiectasis patients with poor response to a first bronchodilator test, unexpectedly improved their lung function after long-term treatment with a bronchodilator, according to a new study. Bronchodilator use is currently recommended only for patients who improve their lung function after an initial test with a short-acting bronchodilator. The study “Effects of long-term bronchodilators in bronchiectasis patients with airflow limitation based on bronchodilator response at baseline” was published in International Journal of Chronic Obstructive Pulmonary Disease. Management of bronchiectasis is based mainly on pharmacological treatment, including the use of anti-inflammatory therapy (inhaled corticosteroids and macrolides) and antibiotics. The responsiveness to a short-acting bronchodilator test is clinically used to measure the flexibility of the bronchi in patients with lung diseases, such as bronchiectasis and chronic obstructive pulmonary disease (COPD), and also to assess if the patient may benefit from long-term treatment. Previous studies have shown that a short-term bronchodilator response is a poor predictor of long-term treatment benefit in COPD patients. However, no studies have explored the link between the early response to bronchodilators and the long-term treatment effects on the lung function of patients with bronchiectasis. A research team investigated 166 patients with bronchiectasis and airflow limitation, and the relationship between the bronchodilator response (BDR) at the beginning of the experiment and lung-function improvement after long-term (3-12 months) bronchodilator therapy. All patients performed a spirometry test to assess lung function before and after inhaling a short-acting bronchodilator, when they were clinically stable, and repeated spirometry after 3-12 months of therapy. Among the 166 patients analyzed, 57 (34%) responded to long-term bronchodilator treatment and improved their lung function; of these patients, 22 had a positive BDR at the beginning of the study. Noteworthy improvements were seen in the patients who did not respond in the first test, with results indicating those patients still may benefit from long-term therapy and should be given special attention. "In summary, we conclude that positive BDR at baseline was an independent predictive factor for improvement in lung function after long-term bronchodilator therapy in patients with bronchiectasis and airflow limitation. We further suggest that clinicians should consider long-term bronchodilator therapy for patients with poor BDR at baseline, as it can exhibit beneficial response," the researchers concluded in their report.