TARGETED LITERATURE REVIEW ASSESSING THE BURDEN OF PSEUDOMONAS AERUGINOSA COLONIZATION IN CHRONIC RESPIRATORY DISEASES
Author(s)
Klas Bergenheim, PhD1, Darsh Devani, MS2, Josefine Emma Persson, PhD1, Grace E. Fox, PhD2.
1AstraZeneca, Gothenburg, Sweden, 2OPEN Health, New York, NY, USA.
1AstraZeneca, Gothenburg, Sweden, 2OPEN Health, New York, NY, USA.
OBJECTIVES: Pseudomonas aeruginosa (PsA) colonization is common and associated with morbidity and mortality in patients with chronic respiratory disease (CRD) such as bronchiectasis (BE), chronic obstructive pulmonary disease (COPD), non-cystic fibrosis bronchiectasis (NCFBE), and cystic fibrosis (CF). This targeted literature review analyzes the evidence on the clinical, economic, and humanistic burden of PsA colonization in CRD.
METHODS: We searched Embase and MEDLINE (inception to July 2025) for English-language studies in patients aged ≥12 years with PsA-colonized BE, COPD, NCFBE, and CF. Eligible designs included economic analyses, health utility studies, observational studies, systematic/non-systematic literature reviews, meta-analyses, and case reports. Outcomes included exacerbation rates, mortality, resource utilization, direct/indirect costs, quality of life (QoL), and utility values.
RESULTS: PsA colonization was associated with increased disease burden across CRDs. Exacerbation risk was significantly increased in PsA-colonized BE (incidence rate ratio, range across studies: 1.2-1.47) and COPD (hazard ratio 1.19-1.5), while no significant association was observed in CF (odds ratio 0.78-1.36). In BE and NCFBE, PsA-colonized patients experienced 0.86-6.92 exacerbations per year compared with 2 or fewer in non-colonized patients. Five-year mortality was higher in PsA-colonized BE (9.7%-50% vs 6.7%-12.5%) and NCFBE (2.6%-48.1% vs 1.9%), while COPD mortality was comparable between PsA-colonized and non-colonized patients. PsA-colonized patients had >2x more hospitalizations, contributing to 2-3x higher annual medical costs; US NCFBE PsA-colonized patients incurred $197k-205k annually versus $71.5k-74.5k in non-colonized patients. PsA colonization was associated with clinically meaningful QoL deficits in BE and NCFBE (SGRQ: +7.5 to +23.5 points) and COPD (COPD Assessment Test: +0.4 to +3 points), with a -0.10 EQ-5D utility decrement in BE patients.
CONCLUSIONS: PsA colonization is associated with a high clinical, economic, and humanistic burden across CRDs. Targeted interventions addressing PsA colonization could meaningfully reduce this burden and limit disease progression across CRDs and improve patients’ quality of life.
METHODS: We searched Embase and MEDLINE (inception to July 2025) for English-language studies in patients aged ≥12 years with PsA-colonized BE, COPD, NCFBE, and CF. Eligible designs included economic analyses, health utility studies, observational studies, systematic/non-systematic literature reviews, meta-analyses, and case reports. Outcomes included exacerbation rates, mortality, resource utilization, direct/indirect costs, quality of life (QoL), and utility values.
RESULTS: PsA colonization was associated with increased disease burden across CRDs. Exacerbation risk was significantly increased in PsA-colonized BE (incidence rate ratio, range across studies: 1.2-1.47) and COPD (hazard ratio 1.19-1.5), while no significant association was observed in CF (odds ratio 0.78-1.36). In BE and NCFBE, PsA-colonized patients experienced 0.86-6.92 exacerbations per year compared with 2 or fewer in non-colonized patients. Five-year mortality was higher in PsA-colonized BE (9.7%-50% vs 6.7%-12.5%) and NCFBE (2.6%-48.1% vs 1.9%), while COPD mortality was comparable between PsA-colonized and non-colonized patients. PsA-colonized patients had >2x more hospitalizations, contributing to 2-3x higher annual medical costs; US NCFBE PsA-colonized patients incurred $197k-205k annually versus $71.5k-74.5k in non-colonized patients. PsA colonization was associated with clinically meaningful QoL deficits in BE and NCFBE (SGRQ: +7.5 to +23.5 points) and COPD (COPD Assessment Test: +0.4 to +3 points), with a -0.10 EQ-5D utility decrement in BE patients.
CONCLUSIONS: PsA colonization is associated with a high clinical, economic, and humanistic burden across CRDs. Targeted interventions addressing PsA colonization could meaningfully reduce this burden and limit disease progression across CRDs and improve patients’ quality of life.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH37
Topic
Economic Evaluation, Epidemiology & Public Health, Patient-Centered Research
Disease
Infectious Disease (non-vaccine), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)