Prevalence of non-cystic fibrosis bronchiectasis in patients with severe asthma: a real-life study

<b>Background:</b> Non-cystic fibrosis bronchiectasis(NCFB) had been demonstrated in about 24-40% of patients with severe asthma and represent a complex phenotype that may impair clinical stability. <b>Aim:</b> To evaluate the prevalence of bronchiectasis in patients with severe asthma and to describe the clinical characteristics of patients with severe asthma and NCFB(SA+NCFB). <b>Materials and Methods:</b> We enrolled 100 patients (59F/41M) with severe asthma. All patients underwent high-resolution computed tomography (HRCT). Two independent radiologists examined HRCTs to confirm BE diagnosis and a third radiologist made the final decision in case of discordance. Personal/pathological anamnesis, smoking status, and exacerbations number were recorded. Pulmonary function test (FEV1), skin prick test, blood eosinophils cells count, total IgE level, fractional exhaled nitric oxide (FeNO), asthma control test (ACT) and sputum characteristic were collected. <b>Results:</b> The prevalence of bronchiectasis in patients with severe asthma was 53% (32 female). The presence of SA+NCFB was associated with a longer history of asthma/years (24.6±15.5 vs. 12.2±5.5; p&lt;0.05), higher level of FeNO/ppb (52.7±37.7 vs, 32.7±20.3;p&lt;0.05), and more frequent exacerbations (64% of patients had more than 5 exacerbations/years in the group of SA+NCFB) compare to patients with SA alone. <b>Conclusion:</b> NCFB impairs clinical outcomes of patients with severe asthma and should be considered predictive of a worse phenotype of severe asthma.