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Title: Bronchiectasis: new therapies and new perspectives
Authors: Chalmers, James D
Chotirmall, Sanjay Haresh
Keywords: Therapies
Issue Date: 2018
Source: Chalmers, J. D., & Chotirmall, S. H. (2018). Bronchiectasis: new therapies and new perspectives. The Lancet Respiratory Medicine, in press.
Series/Report no.: The Lancet Respiratory Medicine
Abstract: European Respiratory Society guidelines for the management of adult bronchiectasis highlight the paucity of treatment options available for patients with this disorder. No treatments have been licensed by regulatory agencies worldwide, and most therapies used in clinical practice are based on very little evidence. Development of new treatments is needed urgently. We did a systematic review of scientific literature and clinical trial registries to identify agents in early-to-late clinical development for bronchiectasis in adults. In this Review, we discuss the mechanisms and potential roles of emerging therapies, including drugs that target airway and systemic inflammation, mucociliary clearance, and epithelial dysfunction. To ensure these treatments achieve success in randomised clinical trials-and therefore reach patients-we propose a reassessment of the current approach to bronchiectasis. Although understanding of the pathophysiology of bronchiectasis is at an early stage, we argue that bronchiectasis is a heterogeneous disease with many different biological mechanisms that drive disease progression (endotypes), and therefore the so-called treatable traits approach used in asthma and chronic obstructive pulmonary disease could be applied to bronchiectasis, with future trials targeted at the specific disease subgroups most likely to benefit.
ISSN: 2213-2600
DOI: 10.1016/S2213-2600(18)30053-5
Rights: © 2018 Elsevier Ltd.
Fulltext Permission: none
Fulltext Availability: No Fulltext
Appears in Collections:LKCMedicine Journal Articles

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