Publications by authors named "Anthony de Soyza"
Background And Objective: This study explored the relationship between total bacterial density, airway microbiota composition and clinical parameters in bronchiectasis. We determined changes with time during clinical stability and following antibiotic treatment of a pulmonary exacerbation.
Methods: We conducted a multicentre longitudinal cohort study of UK participants with CT confirmed bronchiectasis.
Article Synopsis
- - Non-cystic fibrosis bronchiectasis is a chronic lung disease causing symptoms like a persistent cough and frequent flare-ups, with no approved medications specifically for treatment.
- - Current therapies often involve off-label use of drugs, including antibiotics and mucoactive treatments, although their safety has not been confirmed through randomized trials.
- - This review examines the safety of commonly used drugs in treating bronchiectasis and highlights some new treatments under development for the condition.
Article Synopsis
- Researchers wanted to see how digital technology is used in bronchiectasis physiotherapy and ways to make it better.
- They surveyed 48 physiotherapists and 205 patients in Northern Ireland to understand their experiences with technology in care.
- Many physiotherapists didn't use digital tech yet, but most were interested in doing so, and patients wanted more follow-up and better access to services.
Background: In patients with coronavirus disease 2019 (COVID-19) requiring supplemental oxygen, dexamethasone reduces acute severity and improves survival, but longer-term effects are unknown. We hypothesised that systemic corticosteroid administration during acute COVID-19 would be associated with improved health-related quality of life (HRQoL) 1 year after discharge.
Methods: Adults admitted to hospital between February 2020 and March 2021 for COVID-19 and meeting current guideline recommendations for dexamethasone treatment were included using two prospective UK cohort studies (Post-hospitalisation COVID-19 and the International Severe Acute Respiratory and emerging Infection Consortium).
Introduction: Brensocatib is an investigational, oral, reversible inhibitor of dipeptidyl peptidase-1 shown to prolong time to first exacerbation in adults with bronchiectasis. Outlined here are the clinical trial design, and baseline characteristics and treatment patterns of adult patients enrolled in the phase 3 ASPEN trial (NCT04594369).
Methods: The ASPEN trial is a global study enrolling patients with a clinical history consistent with bronchiectasis (cough, chronic sputum production and/or recurrent respiratory infections), diagnosis confirmed radiologically and ≥2 exacerbations in the prior 12 months.
Article Synopsis
- The PHOSP-COVID study examined long-term outcomes in COVID-19 hospitalised patients with pre-existing airway diseases compared to those without.* -
- Out of 615 participants with airway diseases, many reported lower recovery rates, higher anxiety and depression levels, and greater mobility issues one year post-discharge.* -
- Overall, individuals with pre-existing airway conditions experienced worse health-related quality of life and more persistent symptoms like breathlessness and fatigue after recovering from COVID-19.*
Importance: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Observational studies report that β-blocker use may be associated with reduced risk of COPD exacerbations. However, a recent trial reported that metoprolol did not reduce COPD exacerbations and increased COPD exacerbations requiring hospital admission.
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- International guidelines emphasize the importance of airway clearance management in treating bronchiectasis, yet its actual usage across Europe remains unclear.
- A study involving 16,723 patients from 28 countries showed that 52% reported using regular airway clearance, with significant variation in techniques and usage between countries.
- Patients using airway clearance tended to have more severe disease and symptoms, and access to specialized respiratory physiotherapy was notably low, especially in Eastern Europe.
Article Synopsis
- - The study utilized a 4-point sputum colour chart to assess airway inflammation in bronchiectasis patients, analyzing data from 13,484 individuals across 31 countries in the EMBARC registry.
- - Findings revealed that more purulent sputum correlates with worse lung function, a higher severity of the disease, increased frequency of exacerbations, and greater risk of hospitalizations and mortality.
- - The research concluded that sputum colour serves as an effective, straightforward indicator for predicting clinical outcomes and disease severity in bronchiectasis patients.
Article Synopsis
- Rates of mortality and re-admission for patients with COPD after hospitalizations remain high, prompting the need for better inhaler selection and management upon discharge to reduce these risks.
- A study was designed to create a practical inhaler selection tool for clinicians to use prior to discharge and assess its impact on medication prescriptions and patient outcomes.
- The inhaler selection tool was successfully developed through clinician and patient feedback, and consensus was reached on the minimum clinically important differences for re-admissions and mortality rates following exacerbations of COPD.
Background: Asthma is commonly reported in patients with a diagnosis of bronchiectasis.
Objective: The aim of this study was to evaluate whether patients with bronchiectasis and asthma (BE+A) had a different clinical phenotype and different outcomes compared with patients with bronchiectasis without concomitant asthma.
Methods: A prospective observational pan-European registry (European Multicentre Bronchiectasis Audit and Research Collaboration) enrolled patients across 28 countries.
COPD and bronchiectasis are commonly reported together. Studies report varying impacts of co-diagnosis on outcomes, which may be related to different definitions of disease used across studies. To investigate the prevalence of chronic obstructive pulmonary disease (COPD) associated with bronchiectasis and its relationship with clinical outcomes.
View Article and Find Full Text PDFBackground: Increased serum interleukin (IL)-33 predicts poor outcomes in patients hospitalised with coronavirus disease 2019 (COVID-19). We examined the efficacy and safety of tozorakimab, a monoclonal antibody that neutralises IL-33, in improving outcomes in ACCORD-2 (EudraCT: 2020-001736-95).
Methods: ACCORD-2 was an open-label, phase 2a study in adults hospitalised with COVID-19.
Introduction: Bronchiectasis is a long-term lung condition, with dilated bronchi, chronic inflammation, chronic infection and acute exacerbations. Recurrent exacerbations are associated with poorer clinical outcomes such as increased severity of lung disease, further exacerbations, hospitalisations, reduced quality of life and increased risk of death. Despite an increasing prevalence of bronchiectasis, there is a critical lack of high-quality studies into the disease and no treatments specifically approved for its treatment.
View Article and Find Full Text PDFBackground: Regular daily nebulised antibiotics are widely used in managing bronchiectasis. This patient population typically has severe bronchiectasis requiring multiple other medications. Given that little is known about patients' views and preferences for such therapies, this was the focus of our study.
View Article and Find Full Text PDFBackground: The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea.
Methods: We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period).
Background: Bronchiectasis is a heterogeneous, neglected disease with few multicentre studies exploring the causes, severity, microbiology, and treatment of the disease across Europe. This aim of this study was to describe the clinical characteristics of bronchiectasis and compare between different European countries.
Methods: EMBARC is an international clinical research network for bronchiectasis.
Background And Objective: There are limited data on airway clearance treatment (ACT) practices. This study aimed to: 1) assess the feasibility of collecting online surveys on ACTs from patients and physiotherapists and linking the patient survey data to outcome data in the Bronch-UK/EMBARC Registry; 2) assess the association between ACT practices and outcome data; and 3) ascertain the factors affecting physiotherapist ACT practices.
Methods: Survey methodology was used to collect data from patients with bronchiectasis and physiotherapists in Northern Ireland.
Background: Persistence of respiratory symptoms, particularly breathlessness, after acute coronavirus disease 2019 (COVID-19) infection has emerged as a significant clinical problem. We aimed to characterise and identify risk factors for patients with persistent breathlessness following COVID-19 hospitalisation.
Methods: PHOSP-COVID is a multicentre prospective cohort study of UK adults hospitalised for COVID-19.
Introduction: Multimorbidity, the coexistence of two or more chronic conditions, has been extensively studied in certain disease states. Bronchiectasis aetiology is complex and multimorbidity is insufficiently understood. We performed a scoping review, summarising the existing literature and identifying deficits.
View Article and Find Full Text PDFThere is a lack of outcome measures with robust clinimetric properties in bronchiectasis. To determine the clinimetric properties (reliability over 1 year during clinical stability and responsiveness over the course of antibiotics for pulmonary exacerbation) of objective and patient-reported outcome measures. This multicenter cohort study included adults with bronchiectasis from seven hospitals in the United Kingdom.
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