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Association Between Bronchiectasis and Serious Infections in Microscopic Polyangiitis and Granulomatosis With

Satoshi Omura1, Takashi Kida1, Hironori Inoue1

  • 1Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

International Journal of Rheumatic Diseases
|February 11, 2026
PubMed
Abstract

Insights

Bronchiectasis increases serious infections and mortality risk in microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) patients. Initial immunosuppressive treatments did not alter these outcomes, suggesting no need to avoid standard therapies.

Area of Science:

  • Rheumatology
  • Pulmonology
  • Clinical Medicine

Background:

  • Bronchiectasis is more common in microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) than the general population.
  • The impact of bronchiectasis on MPA and GPA patient outcomes and treatment interactions is not well understood.

Purpose of the Study:

  • To investigate the association between bronchiectasis and patient outcomes in MPA and GPA.
  • To explore the influence of immunosuppressive treatment on this association.

Main Methods:

  • A multicenter observational study of 844 adult patients with newly diagnosed or relapsing MPA or GPA.
  • Exposure: clinically apparent bronchiectasis at baseline.
  • Outcomes: serious infections, all-cause mortality, and relapses over 52 weeks, analyzed using multivariable Poisson regression. Treatment interactions were evaluated.

Main Results:

  • 8.1% of patients had bronchiectasis.
  • Bronchiectasis was associated with significantly increased risks of serious infections (IRR: 2.18) and mortality (IRR: 3.07).
  • No significant interaction was found between bronchiectasis and initial immunosuppressive treatments regarding outcomes.

Conclusions:

  • Bronchiectasis is linked to worse outcomes, specifically higher rates of serious infections and mortality, in patients with MPA and GPA.
  • Current immunosuppressive regimens do not appear to modify these risks, indicating standard treatments can be continued.
Keywords:
ANCA‐associated vasculitisbronchiectasisgranulomatosis with polyangiitisinfectionmicroscopic polyangiitismortalitypneumocystis pneumonia

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