bronchiectasis epidemiology forecast insight

DelveInsight’s ‘Bronchiectasis–Epidemiology Forecast—2034’ report delivers an in-depth understanding of the Bronchiectasis, historical and forecasted epidemiology in the United States, EU5 (Germany, Spain, Italy, France, and the United Kingdom), and Japan.

Geographies Covered

• The United States
• EU5 (Germany, France, Italy, Spain, and the United Kingdom)
• Japan

Study Period: 2021-2034

Bronchiectasis Disease Understanding

Bronchiectasis is a chronic lung disease characterized by persistent and lifelong widening of the bronchial airways and weakening of the function mucociliary transport mechanism owing to repeated infection contributing to bacterial invasion and mucus pooling throughout the bronchial tree.

Bronchiectasis was originally described in 1819 by Laennec. The disease was thought to be of waning clinical significance in the 1970’s and 1980’s. However, the prevalence of the disease has resurged as compared to the 2005 data estimating that there were individuals in the United States who had bronchiectasis unrelated to cystic fibrosis and a subsequent epidemiologic study has shown a rising prevalence with an annual change of 8.74% per year. Bronchiectasis affects people across the spectrum of age but the highest prevalence is in women over the age of 60 years (O’Donnell, 2018).

This disorder mostly starts with narrowing of the bronchial tree triggered by an infection, which may lead to the destruction of epithelium if chronic. The disruption of the mucociliary clearance results in retention of secretions and predestines the patient for further infections. In the past, bronchiectasis mostly had infectious causes, such as epidemics of pertussis, measles, and influenza. Presently, the most common cause of bronchiectasis reported in developing countries is the post-infectious route. In contrast, congenital causes of bronchiectasis are seen more often than post-infectious causes in industrialized countries. The development of antibiotic treatments and vaccines has resulted in a continuous decrease in bronchiectasis cases with post-infectious causes in industrial countries.

Historically, the most common cause of bronchiectasis was antecedent respiratory infection, often during childhood. According to present day research, the reported causes of Bronchiectasis are idiopathic, acquired, or infection-related where the main clinical manifestation is a productive cough.

Bronchiectasis is characterized by mild to moderate airflow obstruction that tends to worsen over time. The three most important mechanisms that contribute to the pathogenesis of bronchiectasis are recurrent infections, airway obstruction, and peribronchial fibrosis. The role of exacerbations is important that defines bronchiectasis as a syndrome characterized by permanent bronchial dilatation and recurrent respiratory infections (exacerbations). Various studies have shown that an increased frequency of exacerbations is associated with increased airway and systemic inflammation, and progressive lung damage. In addition, more severe (i.e., requiring hospitalization) and more frequent exacerbations (>2/year) are associated with a worsened quality of life, daily symptoms, decline in lung function, and mortality (Polverino et al., 2018).

Numerous definitions have been given so far to define exacerbations of bronchiectasis. Most of them include an acute change in cough, sputum (color, viscosity, and volume), and several additional symptoms, such as increased dyspnea, wheezing, fatigue, malaise, thoracic pain, spirometric and oxygenation worsening, hemoptysis, fever, etc. Finally, the definition proposed included a deterioration in three or more of the following key symptoms, for at least 48 h: cough; sputum volume and/or consistency; sputum purulence; breathlessness and/or exercise tolerance; fatigue and/or malaise; hemoptysis, and a clinician who determines that a change in bronchiectasis treatment is required. Considering all these factors, it is clear that identification, treatment, and prevention of exacerbation is crucial in the management of bronchiectasis (Polverino et al., 2018).

Even though the etiology of exacerbations is not always clear (bacteria, virus), the factors associated with an increased risk of suffering an exacerbation of bronchiectasis are well described. A broad radiological extension (>2 lobes, bilateral), a cystic aspect, a moderate to severe BSI score, and a history of recurrent exacerbations—are clear predictors of further exacerbations. In particular, the BSI score was developed according to the analysis of risk factors for hospitalizations (severe exacerbations needing hospitalization).

Bronchiectasis refers to the permanent dilation of the bronchi. It is often a sequel of insufficiently treated lung disease that develops into a pathological pattern of dilated bronchi, which heightens susceptibility to further lung infections. Modernization of diagnostic procedures (computed tomography scan) and definition of a clinical picture (repeated lung infections with a chronic cough and persistent sputum production) have raised international awareness of the prevalence of the disease, leading to increasing interest in reviewing and renewing the treatment guidelines.

All patients underwent HRCT of the chest (GE Medical Systems, Light Speed L52002). High-resolution images were obtained in full inspiration for all patients, while expiratory images were acquired for patients suspected to have small airway disease. High-resolution images were obtained at 1 mm collimation at 1-mm intervals from the apices to the lung bases. Images were reconstructed into a bow algorithm using a standard window setting (window level: 700 HU; window width: 1500 HU).

The CT scan was interpreted for the presence of bronchiectasis severity, pattern, distribution, and associated disease processes such as emphysema and small airway disease by two radiologists who were blinded to other clinical and laboratory results; decisions were reached by consensus. The presence of bronchiectasis was based on: (1) lack of tapering of bronchi, (2) bronchial dilatation when its internal diameter was at least 110% larger than the adjacent pulmonary artery, or (3) visualization of the peripheral bronchi within 1 cm of the costal pleural surface or adjacent mediastinal pleural surface.

The treatment of bronchiectasis focuses on managing symptoms, slowing the decline in lung function, and preventing exacerbations. Patients should be encouraged to take general changes that will make a large difference, such as smoking cessation. Chest physiotherapy is a well-established treatment with little in the way of side effects. Some patients may respond to more specialist treatments, such as regular antibiotics, often in the form of a low-dose macrolide three times a week. Frailty and co-morbidities play a role in deciding on the appropriateness of these treatments.

Bronchiectasis Epidemiology

The Bronchiectasis epidemiology division provides insights about the historical and current patient pool along with the forecasted trend for every seven major countries. It helps recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of the DelveInsight report also provides the diagnosed patient pool and their trends along with assumptions undertaken.

Key Findings

The disease epidemiology covered in the report provides historical as well as forecasted Bronchiectasis epidemiology segmented as the Total Prevalent Cases of Bronchiectasis, Prevalence of Bronchiectasis based on Gender, Prevalence of Bronchiectasis based on Comorbidities, Prevalence of Bronchiectasis based on Age. The report includes the Prevalent scenario of Bronchiectasis in 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2021 to 2034.

Country Wise- Bronchiectasis Epidemiology

The epidemiology segment also provides the Bronchiectasis epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.

• The total prevalent population of Bronchiectasis associated in 7MM countries was estimated to be 1,525,523 cases in 2020 and expected to increase at a CAGR of 1.97% for the study period, i.e., 2021-2034.
• As per the estimates, Japan has the highest prevalent population of Bronchiectasis in 7MM.
• Among the EU5 countries, UK had the highest prevalent population of Bronchiectasis. On the other hand, France had the lowest number of case, 44,223 cases in 2020.

Scope of the Report

• Bronchiectasis report covers a detailed overview explaining its causes, symptoms, classification, pathophysiology, diagnosis, and treatment patterns
• Bronchiectasis Epidemiology Report and Model provide an overview of the risk factors and global trends of Bronchiectasis in the seven major markets (7MM: US, France, Germany, Italy, Spain, UK, and Japan)
• The report provides insight into the historical and forecasted patient pool of Bronchiectasis in seven major markets covering the United States, EU5 (Germany, Spain, France, Italy, UK), and Japan
• The report helps recognize the growth opportunities in the 7MM concerning the patient population
• The report assesses the disease risk and burden and highlights the unmet needs of Bronchiectasis
• The report provides the segmentation of the Bronchiectasis epidemiology by prevalent Cases of Bronchiectasis in 7MM
• The report provides the segmentation of the Bronchiectasis epidemiology by Prevalence of Bronchiectasis, Prevalence of Bronchiectasis based on Etiology specific factors, Age-specific cases of Bronchiectasis in 7MM

Report Highlights

• 10-year Forecast of Bronchiectasis  epidemiology
• 7MM Coverage
• Total Prevalent Cases of Bronchiectasis
• Prevalent Cases of Bronchiectasis based on Gender
• Prevalent Cases of Bronchiectasis based on Comorbidities
• Prevalence of Bronchiectasis based on Age

KOL Views

We interview KOLs, and SME’s opinion through primary research to fill the data gaps and validate our secondary research. The opinion helps understand the total patient population and current treatment pattern. This will support the clients in potential upcoming novel treatment by identifying the overall scenario of the indications.

Key Questions Answered

• What will be the growth opportunities in the 7MM concerning the patient population about Bronchiectasis?
• What are the key Findings of Bronchiectasis epidemiology across 7MM, and which country will have the highest number of patients during the forecast period (2025-2034)?
• What would be the total number of patients with Bronchiectasis across the 7MM during the forecast period (2025-2034)?
• Among the EU5 countries, which country will have the highest number of patients during the forecast period (2025-2034)?
• At what CAGR the patient population is expected to grow by 7MM during the forecast period (2025-2034)?
• What are the disease risk, burden, and unmet needs of Bronchiectasis?
• What are the currently available treatments for Bronchiectasis?

Reasons to buy

The Bronchiectasis Epidemiology report will allow the user to -

• Develop business strategies by understanding the trends shaping and driving the global Bronchiectasis  market
• Quantify patient populations in the global Bronchiectasis market to improve product design, pricing, and launch plans
• Organize sales and marketing efforts by identifying the age groups and gender that present the best opportunities for Bronchiectasis therapeutics in each of the markets covered
• Understand the magnitude of Bronchiectasis population by its prevalent cases
• Understand the magnitude of Bronchiectasis population by its clinical manifestation specific cases
• The Bronchiectasis epidemiology report and model was written and developed by Masters and PhD level epidemiologists
• The Bronchiectasis Epidemiology Model developed by DelveInsight is easy to navigate, interactive with dashboards, and epidemiology based on transparent and consistent methodologies. Moreover, the model supports data presented in the report and showcases disease trends over a 10-year forecast period using reputable sources

Key Assessments

• Patient Segmentation
• Disease Risk and Burden
• Risk of disease by the segmentation
• Factors driving growth in a specific patient population