Erdosteine in children and adults with bronchiectasis (BETTER trial): study protocol for a multicentre, double-blind, randomised controlled trial

Chang, Anne B. and Yerkovich, Stephanie T. and Baines, Katherine J. and Burr, Lucy and Champion, Anita and Chatfield, Mark D. and Eg, Kah Peng and Goyal, Vikas and Marsh, Robyn L. and McCallum, Gabrielle B. and McElrea, Margaret and McPhail, Steven and Morgan, Lucy C. and Morris, Peter S. and Nathan, Anne Marie and O'Farrell, Hannah and Sanchez, Marion O. and Parsons, Marianne and Schultz, Andre and Torzillo, Paul J. and West, Nicholas P. and Versteegh, Lesley and Marchant, Julie M. and Grimwood, Keith (2024) Erdosteine in children and adults with bronchiectasis (BETTER trial): study protocol for a multicentre, double-blind, randomised controlled trial. BMJ Open Respiratory Research, 11 (1). e002216. ISSN 2052-4439, DOI https://doi.org/10.1136/bmjresp-2023-002216.

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Official URL: https://doi.org/10.1136/bmjresp-2023-002216

Abstract

Introduction Bronchiectasis is a worldwide chronic lung disorder where exacerbations are common. It affects people of all ages, but especially Indigenous populations in high-income nations. Despite being a major contributor to chronic lung disease, there are no licensed therapies for bronchiectasis and there remain relatively few randomised controlled trials (RCTs) conducted in children and adults. Our RCT will address some of these unmet needs by evaluating whether the novel mucoactive agent, erdosteine, has a therapeutic role in children and adults with bronchiectasis. Our primary aim is to determine in children and adults aged 2-49 years with bronchiectasis whether regular erdosteine over a 12-month period reduces acute respiratory exacerbations compared with placebo. Our primary hypothesis is that people with bronchiectasis who regularly use erdosteine will have fewer exacerbations than those receiving placebo. Our secondary aims are to determine the effect of the trial medications on quality of life (QoL) and other clinical outcomes (exacerbation duration, time-to-next exacerbation, hospitalisations, lung function, adverse events). We will also assess the cost-effectiveness of the intervention.Introduction Bronchiectasis is a worldwide chronic lung disorder where exacerbations are common. It affects people of all ages, but especially Indigenous populations in high-income nations. Despite being a major contributor to chronic lung disease, there are no licensed therapies for bronchiectasis and there remain relatively few randomised controlled trials (RCTs) conducted in children and adults. Our RCT will address some of these unmet needs by evaluating whether the novel mucoactive agent, erdosteine, has a therapeutic role in children and adults with bronchiectasis. Our primary aim is to determine in children and adults aged 2-49 years with bronchiectasis whether regular erdosteine over a 12-month period reduces acute respiratory exacerbations compared with placebo. Our primary hypothesis is that people with bronchiectasis who regularly use erdosteine will have fewer exacerbations than those receiving placebo. Our secondary aims are to determine the effect of the trial medications on quality of life (QoL) and other clinical outcomes (exacerbation duration, time-to-next exacerbation, hospitalisations, lung function, adverse events). We will also assess the cost-effectiveness of the intervention.Introduction Bronchiectasis is a worldwide chronic lung disorder where exacerbations are common. It affects people of all ages, but especially Indigenous populations in high-income nations. Despite being a major contributor to chronic lung disease, there are no licensed therapies for bronchiectasis and there remain relatively few randomised controlled trials (RCTs) conducted in children and adults. Our RCT will address some of these unmet needs by evaluating whether the novel mucoactive agent, erdosteine, has a therapeutic role in children and adults with bronchiectasis. Our primary aim is to determine in children and adults aged 2-49 years with bronchiectasis whether regular erdosteine over a 12-month period reduces acute respiratory exacerbations compared with placebo. Our primary hypothesis is that people with bronchiectasis who regularly use erdosteine will have fewer exacerbations than those receiving placebo. Our secondary aims are to determine the effect of the trial medications on quality of life (QoL) and other clinical outcomes (exacerbation duration, time-to-next exacerbation, hospitalisations, lung function, adverse events). We will also assess the cost-effectiveness of the intervention.Methods and analysis We are undertaking an international multicentre, double-blind, placebo-RCT to evaluate whether 12 months of erdosteine is beneficial for children and adults with bronchiectasis. We will recruit 194 children and adults with bronchiectasis to a parallel, superiority RCT at eight sites across Australia, Malaysia and Philippines. Our primary endpoint is the rate of exacerbations over 12 months. Our main secondary outcomes are QoL, exacerbation duration, time-to-next exacerbation, hospitalisations and lung function.Ethics and dissemination The Human Research Ethics Committees (HREC) of Children's Health Queensland (for all Australian sites), University of Malaya Medical Centre (Malaysia) and St. Luke's Medical Centre (Philippines) approved the study. We will publish the results and share the outcomes with the academic and medical community, funding and relevant patient organisations.Trial registration number ACTRN12621000315819.

Item Type: Article
Funders: The 5-year MRFF project grant (2014419), Thrasher Research Fund (EW 'Al' Thrasher Award, USA), Children's Hospital Foundation (50310), National Health & Medical Research Council (NHMRC) of Australia (1170958) ; (1154302) ; (2025379), Medical Research Future Fund (MRFF) (1193796), Al & Val Rosenstrauss (Rebecca L Cooper Foundation), AusBREATHE (NHMRC 1170958), Queensland Advancing Research fellowship, Royal Australasian College of Physicians' Early Career fellowship (2022REF00054), National Health & Medical Research Council (NHMRC) of Australia (1170958)
Uncontrolled Keywords: Bronchiectasis; Paediatric Lung Disaese
Subjects: R Medicine
Divisions: Faculty of Medicine > Paediatrics Department
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 30 Sep 2024 04:56
Last Modified: 30 Sep 2024 04:56
URI: http://eprints.um.edu.my/id/eprint/45258

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