Imagine a chronic lung condition that leaves patients struggling to breathe, facing frequent flare-ups, and often requiring hospitalization. This is the harsh reality for those living with bronchiectasis, a disease that, until recently, has been largely overlooked by the medical community. But a groundbreaking development is poised to change the game entirely.
At the Irish Thoracic Society Annual Scientific Meeting, held in November 2025 at the picturesque Galway Bay Hotel, experts from around the globe gathered to discuss the latest advancements in respiratory medicine. Among them was Professor James Chalmers, a leading respiratory physician from the University of Dundee, Scotland, and Chief Editor of the European Respiratory Journal. Prof. Chalmers, who runs a specialized clinic for complex respiratory infections at Ninewells Hospital, shared his insights in a compelling lecture titled Big News for Bronchiectasis.
And this is the part most people miss: Bronchiectasis, once considered a rare and insignificant condition, is now recognized as a rapidly growing health concern. Prof. Chalmers emphasized that while it was historically associated with tuberculosis (TB), declining TB rates in regions like Western Europe did not lead to its disappearance. Instead, advancements in CT scanning have revealed a staggering rise in bronchiectasis cases over the past two to three decades.
Patients with bronchiectasis endure a heavy burden, experiencing frequent exacerbations that often require hospitalization. Prof. Chalmers bluntly stated, “This is not a mild disease,” highlighting its complexity and variability. For him, this condition is a personal passion, and his two decades of work in the field have been driven by a mission to uncover better treatment options. “There is a lot happening in bronchiectasis now,” he noted, “but historically, it’s been a neglected area.”
But here’s where it gets controversial: Despite the effectiveness of long-term macrolide therapy in reducing exacerbations, only 17% of European patients receive this treatment. Why? Prof. Chalmers questioned this gap, urging the medical community to address this discrepancy. He also stressed the need for standardized, high-quality care, emphasizing that clinical trials are the cornerstone of progress.
The turning point came earlier this year when the U.S. Food and Drug Administration approved 10mg and 25mg doses of brensocatib, followed by the European Medicines Agency’s (EMA) approval of the 25mg dose in November. This marks the first-ever licensed therapy for bronchiectasis, with clinical trials showing a 20% reduction in exacerbations at both doses. Prof. Chalmers praised the EMA’s decision, noting that the 25mg dose not only reduces exacerbations but also improves lung function and symptoms. “Brensocatib is going to be a game changer,” he declared.
However, this raises a thought-provoking question: With brensocatib leading the way, will other treatments and therapies for bronchiectasis gain the attention they deserve? Prof. Chalmers urged clinicians to adopt a proactive approach, incorporating macrolides as a first-line treatment where appropriate, and exploring additional interventions like exercise, bronchodilators, and supportive therapies. “There is so much we can do for these patients,” he concluded, “and we should strive to improve outcomes for everyone.”
As the medical community celebrates this breakthrough, one thing is clear: bronchiectasis is no longer a forgotten disease. But what do you think? Is brensocatib truly a game changer, or are there other aspects of bronchiectasis treatment that deserve equal attention? Share your thoughts in the comments below!
