The bronchodilator response and clinical characteristics of patients with bronchiectasis

<b>Rationale:</b> Non-cystic fibrosis bronchiectasis (NCFB) is a chronic inflammatory airway disease with significant morbidity and mortality. We studied the association of bronchodilator response and the clinical characteristics of patients with bronchiectasis. <b>Methodology:</b> All patients of the bronchiectasis clinic in between 2014 and Oct 2017 were studied. Significant bronchodilator reversibility was defined by &gt;12% and &gt;200ml change in force expiratory volume in 1 second (FEV1) post-bronchodilator therapy. Group 1 patients had no bronchodilator reversibility, while group 2 had significant reversibility. Demographics, co-morbidities, lung function, rate of emergency department (ED) and hospital admissions were analysed. <b>Results:</b> A total of 195 patients (105 female) with a median age of 69 years were studied. 16 (8.2%) patients had significant bronchodilator reversibility. The median (IQR) FEV1 predicted was similar in both groups (66(51-84) vs.78(54-90),p=0.2). Current smokers were more common in group 2 than 1 (18.8% vs.5.6%,p=0.002). The mean (SD) rate of ED attendance was significantly lower in group 2 (0.65(1.06) vs.0.13(0.34),p&lt;0.001). The hospital admission rate was similar in both groups. The commonest organism from sputum was non tuberculous mycobacterium (NTM) (15.9%). Inhaled corticosteroids (ICS) therapy was more commonly used in group 2 than 1. <b>Conclusion:</b> This study demonstrates the presence of significant bronchodilator reversibility is associated with a lower ED attendance rate. The potential explanations are anti-inflammatory effect of the ICS may have beneficial effect on bronchiectasis airways and these patients are more compliant with treatment.