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

Abstract

BACKGROUND: The association of inhaler use with haemoptysis has rarely been reported in patients with non-cystic fibrosis (CF) bronchiectasis. OBJECTIVE: To elucidate the effect of inhaler use on the development of haemoptysis in patients with non-CF bronchiectasis. METHODS: In a case-crossover study of 192 non-CF bronchiectasis patients with a history of haemoptysis and inhaler use, the risk of haemoptysis associated with the use of inhalers was elucidated. Two inhaled corticosteroids/long-acting beta(2)-agonists (ICS/LABA), one long-acting muscarinic antagonist and one short-acting beta(2)-agonist (SABA) were evaluated. The case and control periods were defined respectively as 0-30 and 180-210 days before haemoptysis. RESULTS: The risk of haemoptysis during the case period was 3.51 times higher than during the control period with any use of inhalers (95 %CI 1.96-6.28). The results of clinically significant haemoptysis 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 haemoptysis (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 beta(2)-agonist, was associated with an increased risk of haemoptysis.