Towards development of evidence to inform recommendations for the evaluation and management of bronchiectasis

Flume, Patrick A.; Basavaraj, Ashwin; Garcia, Bryan; Winthrop, Kevin; Mango, Emily Di; Daley, Charles L.; Philley, Julie V.; Henkle, Emily; O’Donnell, Anne E.; Metersky, Mark L.

doi:10.1016/j.rmed.2023.107217

Cited by 7 publications

(3 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding treatments, there are none licensed by regulatory authorities and many treatments routinely in use lack robust evidence [ 51 ]. In 2023 a report was published wherein a panel of bronchiectasis experts proposed a list of major unanswered questions on this condition [ 52 ]. Key issues and unmet needs identified included more accurate classification of patients to better inform treatment decisions and improved pharmaceutical and clinical management approaches to improve patient outcomes.…”

Section: Bronchiectasismentioning

confidence: 99%

Global respiratory health priorities at the beginning of the 21st century

Greene,

Abdulkadir

2024

Eur Respir Rev

View full text Add to dashboard Cite

Respiratory health has become a prevailing priority amid the diverse global health challenges that the 21st century brings, due to its substantial impact on individuals and communities on a global scale. Due to rapid advances in medicine, emerging knowledge gaps appear along with new challenges and ethical considerations. While breakthroughs in medical science can bring about encouraging possibilities for better treatments and interventions, they also lead to unanswered questions and areas where further research is warranted. A PubMed search on the topic “global respiratory health priorities” between the years 2000 and 2023 was conducted, which returned 236 articles. Of these, 55 were relevant and selected for inclusion in this article. The selection process took into account literature reviews, opinions from expert groups and careful analysis of existing gaps and challenges within the field; our selection encompasses specific infectious and noninfectious respiratory conditions in both adults and children. The global respiratory health priorities identified were selected on the basis that they have been recognised as critical areas of investigation and potential advancement and they span across clinical, translational, epidemiological and population health domains. Implementing these priorities will require a commitment to fostering collaboration and knowledge-sharing among experts in different fields with the ultimate aim to improve respiratory health outcomes for individuals and communities alike.

show abstract

Section: Bronchiectasismentioning

confidence: 99%

Global respiratory health priorities at the beginning of the 21st century

Greene,

Abdulkadir

2024

Eur Respir Rev

View full text Add to dashboard Cite

show abstract

“…The inhaled antibiotics that have been mostly used are off-label, or currently under investigation [ 93 ]. Overall, inhaled antibiotics have shown benefits, especially in sputum volume, bacterial load, quality of life, and exacerbation rates; however, inconsistent results have also been reported between each randomized controlled study [ 79 ].…”

Section: Future Perspectivesmentioning

confidence: 99%

Exacerbation Prevention and Management of Bronchiectasis

Choi¹

2023

Tuberc Respir Dis

View full text Add to dashboard Cite

Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. Despite its increasing prevalence and clinical significance, bronchiectasis was previously regarded as an orphan disease, and ideal treatment of this disease has been poorly understood. The European Respiratory Society and British Thoracic Society have recently published guidelines to assist physicians in the clinical field. Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. In this review, we summarize recent updates on bronchiectasis treatment to prevent exacerbation and manage clinical deterioration.

show abstract

“…Given the dearth of high-quality evidence, international guidelines are based predominantly on low-quality evidence and expert opinion [ 8 ]. Management often focuses on the use of airway clearance, mucoactive agents and antibiotics for acute exacerbations [ 8 , 13 , 14 ]. Long-term antibiotics (inhaled or oral (macrolides)) are recommended for patients with three or more exacerbations annually, but are not suitable for all patients and are associated with the development of drug-resistant pathogens [ 8 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Brensocatib in non-cystic fibrosis bronchiectasis: ASPEN protocol and baseline characteristics

Chalmers,

Burgel,

Daley

et al. 2024

ERJ Open Res

Self Cite

View full text Add to dashboard Cite

Brensocatib is an investigational, oral, reversible inhibitor of dipeptidyl peptidase-1 shown to prolong time to first exacerbation in adults with bronchiectasis. Outlined here are the clinical trial design, and baseline characteristics and treatment patterns of adult patients enrolled in the phase 3 ASPEN trial (NCT04594369).A global study enrolling patients with a clinical history consistent with bronchiectasis (cough, chronic sputum production, and/or recurrent respiratory infections), diagnosis confirmed radiologically, and ≥2 exacerbations in the prior 12 months, ASPEN was designed to evaluate the impact of two brensocatib doses (10 mg and 25 mg) on exacerbation rate over a 52-week treatment periodversusplacebo. Comprehensive clinical data, including demographics, disease severity, lung function,Pseudomonas(P.) aeruginosastatus, and quality of life, were collected at baseline.1682 adults from 35 countries were randomised from December 2020 to March 2023. Mean age was 61.3 years and 64.7% were female. Approximately 70% had moderate-to-severe Bronchiectasis Severity Index (BSI) scores, 29.3% had ≥3 exacerbations in the prior 12 months, and 35.7% were positive forP. aeruginosa. Mean BSI scores were highest in Australia/New Zealand (8.3) and lowest in Latin America (5.9). Overall, the most common aetiology was idiopathic (58.4%). InP. aeruginosa–positiveversus –negative patients, lung function was lower, with greater long-term macrolide (21.5%versus14.0%) and inhaled corticosteroid use (63.5%versus53.9%). There was wide regional variation in long-term antibiotic use in patients with bronchiectasis andP. aeruginosa.ASPEN baseline characteristics and treatment profiles were representative of a global bronchiectasis population.

show abstract

Towards development of evidence to inform recommendations for the evaluation and management of bronchiectasis

Cited by 7 publications

References 84 publications

Global respiratory health priorities at the beginning of the 21st century

Global respiratory health priorities at the beginning of the 21st century

Exacerbation Prevention and Management of Bronchiectasis

Brensocatib in non-cystic fibrosis bronchiectasis: ASPEN protocol and baseline characteristics

Contact Info

Product

Resources

About