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Perspectives on Neuroscience

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Bronchiectasis: new therapies and new perspectives.

James D Chalmers¹, Sanjay H Chotirmall²

¹Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.

The Lancet. Respiratory Medicine

|February 27, 2018

Summary

New treatments for adult bronchiectasis are urgently needed. This review identifies emerging therapies and proposes a "treatable traits" approach for clinical trials to better target patient subgroups.

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Area of Science:

Pulmonology
Clinical Pharmacology

Background:

Current management of adult bronchiectasis lacks licensed treatments and relies on therapies with limited evidence.
There is an urgent need for novel therapeutic strategies to address the limited treatment options for bronchiectasis.

Purpose of the Study:

To identify emerging therapeutic agents in clinical development for adult bronchiectasis.
To discuss the mechanisms and potential roles of these novel therapies.
To propose an optimized clinical trial strategy for bronchiectasis.

Main Methods:

Systematic review of scientific literature.
Screening of clinical trial registries for agents in development for adult bronchiectasis.

Main Results:

Identified several emerging therapies targeting airway inflammation, systemic inflammation, mucociliary clearance, and epithelial dysfunction.
Discussed the mechanisms of action and potential clinical applications of these novel agents.
Highlighted the heterogeneity of bronchiectasis, suggesting distinct endotypes.

Conclusions:

Adult bronchiectasis requires new treatments, with several promising agents in development.
A 'treatable traits' approach, similar to asthma and COPD, could improve the success of future clinical trials by targeting specific patient subgroups.
Reassessing the current approach to bronchiectasis clinical trials is crucial for advancing patient care.