Clinical features associated with a doctor-diagnosis of bronchiectasis in the Severe Asthma Network in Italy (SANI) registry.

BACKGROUND Several severe asthma comorbidities and have been identified. One of the emerging comorbidities is bronchiectasis. We evaluated the frequency of bronchiectasis on severe asthma in a real life setting, by analyzing the data collected by the "Severe Asthma Network Italy" (SANI) registry. METHODS SANI registry encompasses demographic, clinical, functional and inflammatory data of Italian severe asthmatics. Data obtained by the enrolled patients were analyzed, focusing the attention to those patients with concomitant clinically relevant bronchiectasis. RESULTS 15.5% patients have a clinical-radiological diagnosis of bronchiectasis. Bronchiectasis diagnosis was associated with a higher prevalence of chronic rhinosinusitis with nasal polyps (54.6% vs. 38%, p=0.001) and higher serum IgE levels (673.4 vs. 412.1 kUI/L, p=0.013). Patients with bronchiectasis had worse asthma control (ACT: 16.7 vs 18.2, p=0.013), worse quality of life (AQLQ: 4.08 vs. 4.60, p=0.02) and lower lung function (FEV1% predicted 67.3 vs. 75.0, p=0.002). A higher rate of severe asthma exacerbations in the previous 12 months (85.2% vs. 61.5%, p<0.001) was found in patients with bronchiectasis. CONCLUSION severe asthma associated with bronchiectasis represents a particularly severe asthma variant, possibly driven by an eosinophilic endotype. We therefore suggest that bronchiectasis should necessarily be assessed in severe asthmatic patients.