PT  - JOURNAL ARTICLE
AU  - Anthony De Soyza
AU  - Alan Barker
AU  - Daniel Chambers
AU  - Carryer Brent
AU  - Howard Fox
AU  - Fox Howard
AU  - Tobias Welte
AU  - Diana Bilton
TI  - Late-breaking abstract: Safety and efficacy of inhaled mannitol over 12 months in high-risk patients with non-CF bronchiectasis
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2814
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2814.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2814.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - BACKGROUND: Bronchiectasis is a chronic lung condition with increased production of mucus and mucociliary impairment leading to mucus accumulation, cough, sputum production and recurrent infections. Inhaled dry powder mannitol is an osmotic agent that increases the mucus clearance in patients with bronchiectasis.1Patients with frequent exacerbations and marked dyspnoea are at high risk of future exacerbations.2METHODS: A post-hoc sub-group analysis of patients (46 mannitol, 31 control) with frequent exacerbations ( > 2 in past year, and > 4 in the past 2 years) and non-exertional dyspnoea from a multicentre phase III RCT in patients 18 - 85 years old with CT confirmed, non-CF bronchiectasis.1 Patients were randomised to either inhaled mannitol (400mg bd), or control (mannitol 50mg bd) for 1 year.RESULTS:Baseline demographics were similar; total SGRQ scores were 63.4 and 63.7 for mannitol and control respectively. After 1 year there was a significant (45%) reduction in the exacerbation rate in the mannitol group (p=0.0029), and number of days on antibiotics (52%; p=0.024). Further, clinically meaningful (>4 point) improvements were seen in SGRQ scores overall and by domain; total SGRQ score delta -10.65 (p=0.0097). As per the main study, mannitol was well tolerated with event rates similar between arms.DISCUSSION: In this post-hoc subgroup analysis of high-risk patients, mannitol demonstrated a significant reduction in exacerbation rate, antibiotic use and total SGRQ scores on top of existing best standard of care. These findings require a confirmatory study.REFERENCES:Bilton D et al. ERS 2013 (P746)Chalmers JD et al Am J Respir Crit Care Med. 2014 Mar 1;189(5):576-85.