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Review article
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Pre-proof, online 12 January 2026
New perspectives in the treatment of bronchiectasis
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Angela Tramontano1, Mariagiovanna Caporaso1,2, Giulia Macciocchi1,2, Edoardo Simonetta1, Mattia Nigro1,2, Stefano Aliberti1,2,
Corresponding author
stefano.aliberti@hunimed.eu

Corresponding Author: Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy; IRCCS Humanitas Research Hospital, Respiratory Unit, Via Manzoni 56, 20089, Rozzano, Milan, Italy
1 IRCCS Humanitas Research Hospital, Respiratory Unit, Via Manzoni 56, 20089, Rozzano, Milan, Italy
2 Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
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Abstract

Bronchiectasis is a chronic, heterogeneous respiratory disease. Its pathogenesis involves airway inflammation, chronic infection, impaired mucociliary clearance, and progressive lung damage. Despite recent approval of Brensocatib, current management relies mostly on off-label therapies, highlighting the need for evidence-based strategies.

Given the heterogeneity of bronchiectasis, precision medicine approaches that integrate patient phenotypes, endotypes, and disease severity are crucial. Mapping the current landscape of randomized clinical trials (RCTs) highlights the efforts to improve patient outcomes and translate mechanistic insights into clinical practice. This review underscores the shift toward individualized, mechanism-based therapy in bronchiectasis management providing a comprehensive overview of current and emerging therapeutic approaches in bronchiectasis, focusing on ongoing and recent RCTs.

Keywords:
Bronchiectasis
Clinical trials
Emerging therapies
Airway inflammation
Airway infection
Precision medicine
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