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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
PubMed

Insights

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.

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.

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