RESPIRE: breathing new life into bronchiectasis

RESPIRE, definable as "the recovery of hope, courage and strength after a time of difficulty", is apt in the context of bronchiectasis therapy. Despite its recent renaissance, including the publication of the first international guidelines for the management of bronchiectasis, only a single treatment recommendation in the 2017 European Respiratory Society guidelines was supported by high-quality evidence [1]. This is a timely reminder of the real and challenging battle ahead, to deliver evidence-based appropriate and effective therapies to patients. In this issue of the European Respiratory Journal, a major "blow" in this battle has been struck and appears to have landed its intended target [2, 3]. The RESPIRE 1 and 2 trials evaluated 32.5 mg ciprofloxacin dry powder inhalation (DPI) administered twice daily versus placebo in two separate 2x2 arm trials. Taken together, these two trials represent the largest clinical trial programme ever conducted in bronchiectasis. Each trial studied a 14- and 28-day on/off drug regime over a 48-week period. The two trials differed by: 1) their enrolling countries; and 2) statistical handling of the data. RESPIRE 1 largely enrolled across Europe, North and South America, Australia and included Japan, while RESPIRE 2 focused on Asia and Eastern Europe. The inclusion criteria were the same for each set of trials, requiring patients with bronchiectasis infected with one of a list of the most commonly identified pathogens, and a history of ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: CF and non-CF bronchiectasis Editorials Source Type: research