The long term effect of inhaled hypertonic saline 6% in non-cystic fibrosis bronchiectasis

Nicolson, Caroline; Stirling, Robert; Borg, Brigitte M.; Button, Brenda; Wilson, John W.; Holland, Anne E

doi:10.1016/j.rmed.2011.12.021

Cited by 138 publications

(139 citation statements)

References 31 publications

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“…Even at baseline, bronchiectasis-related symptoms overlap significantly with MAC lung disease symptoms and a variety of measures, especially airway clearance strategies, can impact the bronchiectasisrelated symptoms (12)(13)(14)(15)(16)(17)(18)(19). With the exception of universal macrolide administration, however, the approach to bronchiectasis management in this patient cohort was not uniform because many patients were treated by referring physicians for their bronchiectasis.…”

Section: Discussionmentioning

confidence: 96%

Semiquantitative Culture Analysis during Therapy for Mycobacterium avium Complex Lung Disease

Griffith

Adjemian

Brown‐Elliott

et al. 2015

Am J Respir Crit Care Med

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Rationale: Microbiologically based criteria such as sputum culture conversion to negative have traditionally been used to define treatment success for mycobacterial diseases. There are, however, limited data regarding whether nontuberculous mycobacterial sputum culture conversion or semiquantitative culture analysis correlates with subjective or nonmicrobiologic objective indices of treatment response.Objectives: To determine whether a semiquantitative mycobacterial culture scale correlated with clinical disease status and was predictive of long-term sputum mycobacterial culture conversion to negative in a cohort of patients with nodular/ bronchiectatic Mycobacterium avium complex lung disease undergoing therapy.Methods: One hundred and eighty patients undergoing standard macrolide-based therapy for M. avium complex lung disease were monitored at standard frequent intervals with symptomatic, radiographic, and microbiologic data collected, including semiquantitative mycobacterial culture analysis. Analyses were used to evaluate clinical and microbiologic predictors of longterm sputum conversion to culture negative.Measurements and Main Results: After 12 months of therapy, 148 (82%) patients had sputum conversion to culture negative. Baseline semiquantitative sputum culture scores did not differ between patients with sputum conversion and those without. The change in sputum culture semiquantitative score from baseline to Month 3 was highly predictive of subsequent sputum long-term conversion status indicative of treatment success, as was improvement in cough, and especially early radiographic improvement.Conclusions: Early semiquantitative sputum agar plate culture results can be used to predict symptomatic and radiographic improvement as well as long-term sputum culture conversion to negative in this population. We suggest that semiquantitative sputum culture scores can be a useful tool for evaluating new nontuberculous mycobacterial lung disease therapies.

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Section: Discussionmentioning

confidence: 96%

Semiquantitative Culture Analysis during Therapy for Mycobacterium avium Complex Lung Disease

Griffith

Adjemian

Brown‐Elliott

et al. 2015

Am J Respir Crit Care Med

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“…Hypertonic saline may improve forced expiratory volume in 1 s (FEV1) when used in combination with chest physiotherapy but a recent trial could not clearly establish it was superior to 0.9% saline [51,52]. A large trial of hypertonic saline is needed.…”

Section: Inhaled Hyperosmolar Agents and Mucolyticsmentioning

confidence: 99%

Management of bronchiectasis in adults

2015

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Formerly regarded as a rare disease, bronchiectasis is now increasingly recognised and a renewed interest in the condition is stimulating drug development and clinical research. Bronchiectasis represents the final common pathway of a number of infectious, genetic, autoimmune, developmental and allergic disorders and is highly heterogeneous in its aetiology, impact and prognosis.The goals of therapy should be: to improve airway mucus clearance through physiotherapy with or without adjunctive therapies; to suppress, eradicate and prevent airway bacterial colonisation; to reduce airway inflammation; and to improve physical functioning and quality of life.Fortunately, an increasing body of evidence supports interventions in bronchiectasis. The field has benefited greatly from the introduction of evidence-based guidelines in some European countries and randomised controlled trials have now demonstrated the benefit of long-term macrolide therapy, with accumulating evidence for inhaled therapies, physiotherapy and pulmonary rehabilitation.This review provides a critical update on the management of bronchiectasis focussing on emerging evidence and recent randomised controlled trials. @ERSpublications Bronchiectasis is a rapidly developing field: review of recent RCTs and progress towards developing new therapies

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“…1) The active and control treatments might not have been sufficiently distinct: isotonic saline could also benefit patients by humidifying airway surface liquid [8], and quinine sulfate, the bitter compound used for taste-masking in both groups, has been reported to stimulate ciliary frequency and have bronchodilatory effects [9,10]. 2) HS might not have been administered in the most effective way.…”

Section: What the Study Foundmentioning

confidence: 99%

“…A treatment that works for CF or non-CF bronchiectasis [8,25] might not for PCD. We must conduct studies including only patients with state-of-the-art diagnoses of PCD [4].…”

Section: Family Support and Role Of Patient Organisationsmentioning

confidence: 99%

Hypertonic saline in patients with primary ciliary dyskinesia: on the road to evidence-based treatment for a rare lung disease

2017

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The long term effect of inhaled hypertonic saline 6% in non-cystic fibrosis bronchiectasis

Cited by 138 publications

References 31 publications

Semiquantitative Culture Analysis during Therapy for Mycobacterium avium Complex Lung Disease

Semiquantitative Culture Analysis during Therapy for Mycobacterium avium Complex Lung Disease

Management of bronchiectasis in adults

Hypertonic saline in patients with primary ciliary dyskinesia: on the road to evidence-based treatment for a rare lung disease

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