Bronchiectasis: an update on current pharmacotherapy and future perspectives.

Abstract

INTRODUCTION:

Bronchiectasis is a common condition and is likely to be underestimated, as bronchiectasis is now a recognised problem complicating other chronic lung diseases such as severe asthma, severe chronic obstructive pulmonary disease and advanced pulmonary fibrosis. In more advanced bronchiectasis, there is a vicious cycle of excess neutrophilic airways inflammation and chronic infection of the airways. This leads to the clinical syndrome, including a chronic productive cough and recurrent chest infections.

AREAS COVERED:

This review provides an overview of the current pharmacotherapy options available and the potential future perspectives for treatment in adult patients with idiopathic or post-infection bronchiectasis. A PUBMED search for all Phase III and above trials on current therapies focusing on optimising airway dilatation and treatments to break the vicious cycle of infection and inflammation were sought. These therapies include antibiotics, anti-inflammatory and mucoactive therapies alongside chest physiotherapy. Landmark Phase II studies were also included.

EXPERT OPINION:

Current practice has predominantly been based on treatment advised from national guidelines that are mainly grade D expert opinion. Randomised controlled trials are greatly needed to improve practice of evidence-based medicine.

• Authors: Manjit K Sidhu, Pallavi Mandal, Adam T Hill
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 15 Issue 4 Pg. 505-25 (Mar 2014) ISSN: 1744-7666 [Electronic] England
• PMID: 24410485 (Publication Type: Journal Article, Review)

Chemical References

• Adrenal Cortex Hormones
• Anti-Bacterial Agents
• Anti-Inflammatory Agents, Non-Steroidal
• Bronchodilator Agents
• Hydroxymethylglutaryl-CoA Reductase Inhibitors

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Bronchiectasis (drug therapy, microbiology, physiopathology)
• Bronchodilator Agents (therapeutic use)
• Clinical Trials as Topic
• Disease Progression
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Inflammation (drug therapy)
• Mucociliary Clearance (drug effects)
• Respiratory Tract Infections (drug therapy)