A systematic review of pharmacotherapeutic clinical trial end-points for bronchiectasis in adults

Megan L. Crichton, Stefano Aliberti, James D. Chalmers

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Bronchiectasis is an increasing clinical problem, but multiple recent clinical trials have failed to reach their primary end-point. Difficulties in achieving “positive” bronchiectasis trials is reflected in a lack of agreement from trialists and regulators on what are the optimal end-points. To evaluate the use of end-points in bronchiectasis trials, we conducted a systematic review of published bronchiectasis trials from 2008 to 2018 and extracted end-points used, definitions, methods of analysis and responsiveness. Our analysis shows that quality of life and exacerbation end-points are most frequently used. Trials using exacerbation end-points have been characterised by varying definitions, multiple methods of analysis and durations of follow-up. There are multiple quality of life tools for bronchiectasis (Quality of Life - Bronchiectasis questionnaire, St George’s Respiratory Questionnaire, etc.). The majority of studies measure lung function (e.g. forced expiratory volume in 1 s), but this is shown to be nonresponsive to the majority of interventions. Microbiology end-points frequently show statistically significant differences in phase 2 antibiotic studies but their correlation with clinical end-points is unknown. This systematic review demonstrates a need for guidance to standardise definitions and design features to improve reproducibility and increase the likelihood of demonstrating statistically significant benefits with new therapies.

Original languageEnglish
Article number180108
JournalEuropean Respiratory Review
Volume28
Issue number151
DOIs
Publication statusPublished - Mar 31 2019

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Bronchiectasis
Clinical Trials
Quality of Life
Forced Expiratory Volume
Microbiology
Anti-Bacterial Agents
Lung

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

A systematic review of pharmacotherapeutic clinical trial end-points for bronchiectasis in adults. / Crichton, Megan L.; Aliberti, Stefano; Chalmers, James D.

In: European Respiratory Review, Vol. 28, No. 151, 180108, 31.03.2019.

Research output: Contribution to journalReview article

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