Evaluating Success of Therapy for Bronchiectasis: What End Points to Use?

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Management strategies for chronic bronchectasis

The aims of management of bronchiectasis are to reduce symptoms (reduce cough frequency and severity, improve sputum volume and purulence, and reduce breathlessness, chest pain, and fatigue), reduce exacerbation frequency and severity, preserve lung function, and improve health-related quality-of-life. The impact of bronchiectasis on mortality is unclear, but studies have explored factors that may predict mortality, and these should be considered in the management of bronchiectasis.3, 4, 5

Lung Function

Lung function, typically the FEV1 and FVC, are frequently and reliably used as markers of treatment efficacy in the management of other chronic respiratory diseases such as cystic fibrosis and asthma. Many interventional studies in bronchiectasis also report the effect of treatment on these parameters (Table 1). Irrespective of the intervention studied, most of these studies have not observed any significant change in FEV1 or FVC. The few studies that do report a statistical improvement achieve

Summary

Bronchiectasis is responsible for significant morbidity and frequent utilization of health care resources. Over the past few decades it has become increasingly recognized that effective, evidence-based treatment strategies are necessary. To effectively assess a treatment strategy, clear and validated end points are needed. For a parameter to be useful in disease management, it is must be pertinent to the condition, noninvasive, inexpensive, easily accessible, reliable, and responsive to change.

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