Effect of inhalers on the development of hemoptysis in patients with non-cystic fibrosis bronchiectasis

Abstract

Introduction: The association of inhaler use with hemoptysis has rarely been reported in patients with non-cystic fibrosis (CF) bronchiectasis. We aimed to elucidate the effect of inhaler use on the development of hemoptysis in patients with non-CF bronchiectasis. Methods: In a case-crossover study of 192 non-CF bronchiectasis patients with a history of hemoptysis and inhaler use, the risk of hemoptysis associated with the use of inhalers was elucidated. Two inhaled corticosteroids/long-acting β2-agonists (ICS/LABA), one long-acting muscarinic antagonist (LAMA), and one short-acting β2-agonist (SABA) were evaluated. The case and control periods were defined respectively as 0-30 days and 180-210 days before hemoptysis. Results: The risk of hemoptysis during the case period was 3.51 times higher than during the control period with any use of inhalers (95% confidence interval (CI), 1.96-6.28). The results of clinically significant hemoptysis showed good agreement with those of total events. These associations were consistent with the sensitivity analyses. In the sub-analysis according to inhaler type, ICS/LABA and SABA were significantly associated with an increased risk of hemoptysis (aOR 2.62, 95% CI 1.25-5.45

aOR 2.51, 95% CI 2.23-5.15). Conclusions: In patients with non-CF bronchiectasis, the use of inhalers, especially including β2-agonist, was associated with an increased risk of hemoptysis.