The impact of COPD-bronchiectasis association on clinical outcomes: insights from East Asian cohorts validating the ROSE criteria.
Journal
ERJ open research
Journal Volume
11
Journal Issue
2
Start Page
Article number 00626-2024
ISSN
2312-0541
Date Issued
2025-03
Author(s)
Lu, Kai-Zen
Chen, Ying-Yin
Hung, Zheng-Ci
Hsiao, Yi-Han
Sheu, Chau-Chyun
Wang, Ping-Huai
Hsieh, Meng-Heng
Hsu, Wu-Huei
Chen, Ming-Tsung
Ou, Wei-Fan
Wei, Yu-Feng
Yang, Tsung-Ming
Lan, Chou-Chin
Wang, Cheng-Yi
Lin, Chih-Bin
Lin, Ming-Shian
Wang, Yao-Tung
Lin, Ching-Hsiung
Liu, Shih-Feng
Cheng, Meng-Hsuan
Cheng, Wen-Chien
Peng, Chung-Kan
Chan, Ming-Cheng
Jao, Lun-Yu
Wang, Ya-Hui
Chen, Ching-Yi
Chen, Chi-Jui
Chen, Shih-Pin
Tsai, Yi-Hsuan
Cheng, Shih-Lung
Lin, Horng-Chyuan
Abstract
Background The radiology, obstruction, symptoms and exposure (ROSE) criteria provide a standardised approach for identifying the “COPD–bronchiectasis (BE) association.” However, the clinical implications and outcomes of the COPD–BE association in East Asian populations remain unclear. Our study applied the ROSE criteria to assess the prevalence, clinical impact and outcomes of the COPD–BE association in an East Asian cohort, and compared that cohort with nonsmoking BE patients with fixed airflow obstruction (FAO) and those without FAO. Methods An integrated cohort analysis was conducted within a Taiwanese demographic, combining a prospective cohort of 147 participants with a multicentre retrospective cohort of 574 participants. Stratification was based on the ROSE criteria, distinguishing between nonsmoking BE, smoking BE, nonsmoking BE with FAO and BE in compliance with the ROSE criteria. Clinical, radiological and spirometric variables were assessed in conjunction with outcomes to validate the diagnostic utility of the criteria. Results Using the ROSE criteria, we found that 16.5% of participants had a COPD–BE association (22.4% in the prospective cohort and 14.9% in the retrospective cohort), predominantly in older male patients. These patients had escalated dyspnoea scores, higher COPD diagnosis rates and increased use of inhalation therapies, compared with those without FAO. Notably, patients with a COPD–BE association and nonsmoking BE with FAO displayed similar clinical symptoms, pulmonary function and disease severity, but differed slightly in airway microbiology. Furthermore, patients with a COPD–BE association had significantly higher risks of exacerbations and hospitalisations, even after adjusting for confounding factors, which highlights that they have poorer clinical outcomes than other groups. Conclusion The ROSE criteria effectively identify the COPD–BE association in East Asian populations, highlighting a significant future exacerbation risk compared with other BE groups. Future research is warranted to better understand BE progression, especially in FAO subgroups.
Type
journal article