Incidence of Non-CF Bronchiectasis is Rising in Germany, Study Reports

The incidence of non-cystic fibrosis bronchiectasis is rising in Germany, which necessitates a better understanding of the economic burden of the disease, a new study reports.

The study, “Incidence of patients with non-cystic fibrosis bronchiectasis in Germany – A healthcare insurance claims data analysis,” was published in the journal Respiratory Medicine.

Bronchiectasis is a chronic pulmonary disease that is characterized by permanently dilated airways due to chronic bronchial inflammation. A common and well-known cause of bronchiectasis is cystic fibrosis (CF). However, bronchiectasis can also be caused by conditions other than CF, which is referred to as non-cystic fibrosis bronchiectasis (NCFB).

Epidemiological data on the incidence and prevalence of NCFB in Europe is needed to accurately determine the number of resources that are required for treatment, but currently this information is limited, the study stated.

“Real-life data on the upcoming burden of NCFB in Europe is completely lacking,” the researchers said.

Therefore, they conducted an investigation to assess the overall incidence of NCFB in Germany, as well as the clinical and demographic variables of this patient population.

The team used data from a representative sample of nearly four million people who were covered by Germany’s public health insurance to identify 728 patients with NCFB in 2013.

Next, they extrapolated the finding to the entire German population, which led to an estimate of 17,095 patients newly diagnosed with NCFB in 2013. This corresponded to an incidence of 21.23 per 100,000 inhabitants of Germany.

“Whereas NCFB has previously been neglected and classified as an ‘orphan disease,’ our study results support the assumption that it is much more frequent,” the researchers wrote.

The majority of the NCFB patients (98.4%) were at least 18 years old, and a slight majority (52.7%) of the patients were male.

The researchers also found a rise in NCFB incidence in Germany between 2011 and 2013.

The most common diseases that predisposed patients to the development of NCFB included chronic obstructive pulmonary disease (41.4%), asthma (32.8%), and gastroesophageal reflux (18.3%). Additionally, the researchers observed that 28.2% of NCFB patients had coronary heart disease.

Patients with bronchiectasis were frequently and chronically infected with bacterial pathogens, which were found to be present in 10.7% of the NCFB patients analyzed.

For treatment, 58.4% of the patients had received antiobstructive inhalative medications. Among adult patients, 51.6% were prescribed antibiotics.

“The peak of antibiotic treatment was observed in the 75–79 age group for males, and 70–74 and 75–79 years for females,” the researchers wrote.

Among those diagnosed in 2013, 8% of the adult NCFB patients who received antibiotic treatment had to be hospitalized.

The majority of the diagnosed patients (54.1%) received at least two prescriptions in 2013, indicating that hospitalizations were not the only healthcare expenditure for this patient population.

The results indicate that “the incidence of NCFB in Germany appears to be rising,” the researchers wrote. “NCFB patients have a considerable resource use by antibiotic treatment in the outpatient setting, even during the first year of establishing the diagnosis.”

“Given the increasing recognition of NCFB, a better understanding of the economic burden of the disease is required, with a view towards improving patient management,” the team stated. “For this, more detailed, prospective studies are needed.”