Bronchiectasis · Mucoactive treatment
Aerosolized recombinant human DNase in idiopathic bronchiectasis
| Design | Randomised, double-blind, placebo-controlled multicentre trial |
|---|---|
| Treatment | Aerosolised recombinant human DNase twice daily |
| Control | Placebo |
| Population | 349 adults with idiopathic bronchiectasis |
| Follow-up | 24 weeks |
| Primary endpoint | Exacerbation rate and change in FEV1 |
| Result | Pulmonary exacerbations were more frequent and FEV1 decline was greater with rhDNase than with placebo over the 24-week treatment period. |
| Secondary endpoints | Hospitalisation, antibiotic use, adverse events |
rhDNase was ineffective and potentially harmful in this group of adult outpatients in stable condition with idiopathic bronchiectasis. This contrasts with previously published results that demonstrated efficacy of rhDNase in patients with cystic fibrosis bronchiectasis.
The trial authors, in the published abstract
The cautionary tale of extrapolating from cystic fibrosis, where dornase alfa is a mainstay, to bronchiectasis of other cause, where it is harmful. Same radiographic pattern, different sputum biology. Worth remembering whenever a CF therapy is proposed for non-CF bronchiectasis.
O'Donnell AE, Barker AF, Ilowite JS, et al. Treatment of idiopathic bronchiectasis with aerosolized recombinant human DNase I. rhDNase Study Group. Chest 1998 May;113(5):1329-34.