{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T15:11:29Z","timestamp":1767625889874,"version":"3.41.2"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG3H0931; CMRPG3K2061"],"award-info":[{"award-number":["CMRPG3H0931; CMRPG3K2061"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>The information regarding bronchiectasis with RA (BROS) is limited in Asia. The objective of this study was to investigate the clinical characteristics and outcomes of BROS in Taiwan. This multi-institute cohort study included patients with BROS from January 2006 to December 2017. The clinical, functional and microbiological data of these patients were retrieved from the Chang Gung Research Database. Respiratory failure and mortality were the primary outcomes. Severe exacerbation was defined as bronchiectasis- related hospitalizations or emergency department visits. A total of 343 patients with BROS were identified. One hundred and eight patients had severe exacerbation and exhibited significantly more previous exacerbations, a lower FEV1 and higher BACI score (11.1 vs. 7.5) than patients without severe exacerbation. The most prevalent species in sputum were Non-tuberculous mycobacteria (NTM) (14.8 %), <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (14.2 %), and <jats:italic>fungus<\/jats:italic> (5.9%). 68.8% of BROS patients used disease modifying antirheumatic drugs (DMARD), 7.9% used biological DMARD. NTM and tuberculosis infection rates were higher in bDMARD group compared with nbDMARD group and others. Overall, the 3-year respiratory failure rate and mortality rate were 14.6 and 25.7% respectively. Patients with RA diagnosed before bronchiectasis had a significantly higher cumulative incidence of mortality in a 3-year follow-up than those with RA diagnosed after bronchiectasis. In Cox regression, age, higher RF value and systemic steroid use were independent risk factors for mortality in BROS. BROS patients with severe exacerbation had a high mortality rate in Taiwan. bDMARD is associated with a trend of increased risk of NTM and TB infections.<\/jats:p>","DOI":"10.3389\/fmed.2022.1004550","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T05:58:51Z","timestamp":1665640731000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical outcomes and prognostic factors of bronchiectasis rheumatoid overlap syndrome: A multi-institution cohort study"],"prefix":"10.3389","volume":"9","author":[{"given":"Horng-Chyuan","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Yu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Yu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueh-Fu","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiung-Hung","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Tung","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiung-Hsin","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Hua","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jhen-Ling","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting-Wei","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng-Heng","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1016\/S0140-6736(18)31767-7","article-title":"Advances in bronchiectasis: endotyping, genetics, microbiome, and disease heterogeneity","volume":"392","author":"Flume","year":"2018","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1016\/S2213-2600(16)30320-4","article-title":"Comorbidities and the risk of mortality in patients with bronchiectasis: an international multicentre cohort study","volume":"4","author":"McDonnell","year":"2016","journal-title":"Lancet Respir Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"812775","DOI":"10.3389\/fmed.2021.812775","article-title":"Influence of comorbidities and airway clearance on mortality and outcomes of patients with severe bronchiectasis exacerbations in Taiwan","volume":"8","author":"Huang","year":"2021","journal-title":"Front Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"4542","DOI":"10.3390\/jcm10194542","article-title":"Clinical characteristics of patients with post-tuberculosis bronchiectasis: findings from the KMBARC registry","volume":"10","author":"H Choi","year":"2021","journal-title":"J Clin Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1183\/09031936.00064014","article-title":"RA autoantibodies as predictors of rheumatoid arthritis in non-cystic fibrosis bronchiectasis patients","volume":"44","author":"Perry","year":"2014","journal-title":"Eur Respir J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1016\/j.chest.2016.12.024","article-title":"Bronchiectasis rheumatoid overlap syndrome is an independent risk factor for mortality in patients with bronchiectasis: a multicenter cohort study","volume":"151","author":"De Soyza","year":"2017","journal-title":"Chest."},{"key":"B7","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/j.jbspin.2019.12.006","article-title":"Bronchiectasis in rheumatoid arthritis. A clinical appraisial","volume":"87","author":"Duarte","year":"2020","journal-title":"Joint Bone Spine."},{"key":"B8","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1164\/rccm.201309-1575OC","article-title":"The bronchiectasis severity index an international derivation and validation study","volume":"189","author":"Perry","year":"2014","journal-title":"Am J Respir Crit Care Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2003","DOI":"10.1111\/1756-185X.12702","article-title":"Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co-existent bronchiectasis","volume":"20","author":"Perry","year":"2017","journal-title":"Int J Rheum Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1186\/1471-2334-11-304","article-title":"Risk of infections in bronchiectasis during disease-modifying treatment and biologics for rheumatic diseases","volume":"11","author":"Geri","year":"2011","journal-title":"BMC Infect Dis."},{"key":"B11","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.rbre.2012.12.001","article-title":"A systematic review of the influence of anti-TNF on infection rates in patients with rheumatoid arthritis","volume":"53","author":"Goh","year":"2013","journal-title":"Rev Bras Reumatol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e110922","DOI":"10.1371\/journal.pone.0110922","article-title":"Rheumatoid arthritis increases the risk of nontuberculosis mycobacterial disease and active pulmonary tuberculosis","volume":"9","author":"Yeh","year":"2014","journal-title":"PLoS ONE."},{"key":"B13","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1111\/1756-185X.12970","article-title":"Comparison of the risk of infections in different anti-TNF agents: a meta-analysis","volume":"20","author":"H Liao","year":"2017","journal-title":"Int J Rheum Dis."},{"key":"B14","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.bj.2017.08.002","article-title":"Chang Gung research database: a multi-institutional database consisting of original medical records","volume":"40","author":"Tsai","year":"2017","journal-title":"Biomed J."},{"key":"B15","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1002\/pds.4713","article-title":"The Chang Gung Research Database-A multi-institutional electronic medical records database for real-world epidemiological studies in Taiwan","volume":"28","author":"Shao","year":"2019","journal-title":"Pharmacoepidemiol Drug Saf."},{"key":"B16","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s12890-020-1080-7","article-title":"Etiology and characteristics of patients with bronchiectasis in Taiwan: a cohort study from 2002 to 2016","volume":"20","author":"Huang","year":"2020","journal-title":"BMC Pulm Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"e013151","DOI":"10.1136\/bmjopen-2016-013151","article-title":"Risk of obstructive sleep apnoea in patients with rheumatoid arthritis: a nationwide population-based retrospective cohort study","volume":"6","author":"Shen","year":"2016","journal-title":"BMJ Open."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e018290","DOI":"10.1161\/JAHA.120.018290","article-title":"Patients with rheumatoid arthritis with an inadequate response to disease-modifying antirheumatic drugs at a higher risk of acute coronary syndrome","volume":"10","author":"Hsu","year":"2021","journal-title":"J Am Heart Assoc."},{"key":"B19","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.jmii.2017.08.014","article-title":"Influenza vaccination and risk of respiratory failure in patients with chronic obstructive pulmonary disease: a nationwide population-based case-cohort study","volume":"52","author":"Huang","year":"2019","journal-title":"J Microbiol Immunol Infect."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1700051","DOI":"10.1183\/13993003.00051-2017","article-title":"Pulmonary exacerbation in adults with bronchiectasis: a consensus definition for clinical research","volume":"49","author":"Hill","year":"2017","journal-title":"Eur Respir J."},{"key":"B21","doi-asserted-by":"publisher","first-page":"908","DOI":"10.3389\/fphar.2019.00908","article-title":"The association between usage of colchicine and pneumonia: a nationwide, population-based cohort study","volume":"10","author":"Tsai","year":"2019","journal-title":"Front Pharmacol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1513\/AnnalsATS.201506-333OC","article-title":"A comprehensive analysis of the impact of pseudomonas aeruginosa colonization on prognosis in adult bronchiectasis","volume":"12","author":"Finch","year":"2015","journal-title":"Ann Am Thorac Soc."},{"key":"B23","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1183\/09031936.05.00034805","article-title":"Standardisation of spirometry","volume":"26","author":"Miller","year":"2005","journal-title":"Eur Respir J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"e0193489","DOI":"10.1371\/journal.pone.0193489","article-title":"Estimating the response and economic burden of rheumatoid arthritis patients treated with biologic disease-modifying antirheumatic drugs in Taiwan using the national health insurance research database (NHIRD)","volume":"13","author":"Shi","year":"2018","journal-title":"PLoS ONE"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2177","DOI":"10.1007\/s10067-020-05567-6","article-title":"Factors that influence biological survival in rheumatoid arthritis: results of a real-world academic cohort from the Netherlands","volume":"40","author":"van Mulligen","year":"2021","journal-title":"Clin Rheumatol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1700629","DOI":"10.1183\/13993003.00629-2017","article-title":"European Respiratory Society guidelines for the management of adult bronchiectasis","volume":"50","author":"Polverino","year":"2017","journal-title":"Eur Respir J."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1164\/rccm.201711-2202OC","article-title":"Characterization of the \u201cfrequent exacerbator phenotype\u201d in bronchiectasis","volume":"197","author":"Chalmers","year":"2018","journal-title":"Am J Respir Crit Care Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/j.autrev.2019.05.005","article-title":"Rheumatoid arthritis (RA) and cardiovascular disease","volume":"18","year":"2019","journal-title":"Autoimmun Rev."},{"key":"B29","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1093\/rheumatology\/31.10.691","article-title":"Bronchiectasis and rheumatoid disease: is there an association?","volume":"31","author":"Solanki","year":"1992","journal-title":"Br J Rheumatol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1097\/00005792-199405000-00005","article-title":"Bronchiectasis A late feature of severe rheumatoid arthritis","volume":"73","author":"Shadick","year":"1994","journal-title":"Medicine."},{"key":"B31","first-page":"801","article-title":"Rheumatoid arthritis and bronchiectasis A retrospective study of fourteen cases","volume":"63","author":"Despaux","year":"1996","journal-title":"Rev Rhum Engl Ed."},{"key":"B32","doi-asserted-by":"publisher","first-page":"2335","DOI":"10.1002\/art.39226","article-title":"Bronchiectasis is a model for chronic bacterial infection inducing autoimmunity in rheumatoid arthritis","volume":"67","author":"Quirke","year":"2015","journal-title":"Arthritis Rheumatol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.2147\/IDR.S169789","article-title":"Impact of concomitant nontuberculous mycobacteria and Pseudomonas aeruginosa isolates in non-cystic fibrosis bronchiectasis","volume":"11","author":"Hsieh","year":"2018","journal-title":"Infect Drug Resist."},{"key":"B34","doi-asserted-by":"publisher","first-page":"868435","DOI":"10.3389\/fmicb.2022.868435","article-title":"Impacts of nontuberculous mycobacteria isolates in non-cystic fibrosis bronchiectasis: a 16-year cohort study in Taiwan","volume":"13","author":"Lin","year":"2022","journal-title":"Front Microbiol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1004550\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T05:58:56Z","timestamp":1665640736000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1004550\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,13]]},"references-count":34,"alternative-id":["10.3389\/fmed.2022.1004550"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.1004550","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2022,10,13]]},"article-number":"1004550"}}