Developing drug therapies in bronchiectasis.

Introduction: Bronchiectasis is a chronic respiratory condition characterised by cough, sputum production and recurrent chest infections. There are multiple aetiologies; but in up to 50% of patients, the aetiology is unknown. The treatment is largely symptomatic with regular chest physiotherapy and antibiotics for infective exacerbations. Research is being directed towards breaking the 'vicious circle' of bronchiectasis with therapies directed at improving mucociliary clearance, treating chronic infection and reducing inflammation in the airways. Areas covered: This review highlights the current status of bronchiectasis research, summarising reported and ongoing studies of potential therapeutic agents not yet assessed in large trials or licensed for treatment. A literature review was performed using the PubMed database and upcoming trials were sought on the ClinicalTrials.gov website. The article is limited to studies in preclinical to Phase II clinical trials. The trials highlighted in this article offer insight into potential therapeutic agents for the future and help highlight areas in need of further targeted research. Expert opinion: There are promising new anti-infective and anti-inflammatory therapies for more advanced bronchiectasis. That being said, Phase III studies are still needed to investigate these agents further, as well as at what stage therapy should be implemented.