Brensocatib, a competitive and reversible oral DPP1 inhibitor, at 10 and 25 mg significantly reduced pulmonary exacerbation burden, and 25 mg also reduced lung function decline vs. placebo in patients with non-cystic fibrosis bronchiectasis, hereafter bronchiectasis, in ASPEN (NCT04594369). A population pharmacokinetic (PPK) model was developed to support brensocatib dose selection for adults and adolescents. Data from 11 clinical trials were pooled for analysis. The covariate model was developed via a stepwise approach. Clinical relevance of statistically significant covariates was assessed by simulated brensocatib exposure at steady state in various subgroups with different characteristics relative to a reference subject (healthy White male, 49 years, 70 kg, fasted, no concomitant medications). Covariate effects on brensocatib PK were evaluated. From 291 healthy participants and 807 patients, 11,643 brensocatib plasma concentrations were used for PPK model construction. Body weight was integrated using standard allometric scaling coefficients of 0.75 on total and intercompartment clearance (CL/F and Q/F) and 1.0 on central and peripheral volume of distribution (Vc/F and Vp/F). Statistically significant covariates included hepatic impairment, sex, race, and co-medication use (strong CYP3A and Pgp modulators) on CL/F; age on Vc/F; food effect on Ka; and co-medications (strong CYP3A and Pgp inhibitors) on relative bioavailability. Disease populations, renal impairment, and tablet formulations were not statistically significant covariates. The PPK model provided a robust fit to observed brensocatib concentration time profiles in bronchiectasis patients. No identified covariates were clinically relevant. This analysis supported brensocatib dosage of 10 and 25 mg in patients with bronchiectasis ≥ 12 years without dose adjustment.

Bronchiectasis patients have a substantial cardiovascular risk burden. Despite high rates of screening, one in three are at moderate-high 10-year risk, highlighting the need to integrate cardiovascular risk assessment into care pathways. https://bit.ly/48BUigN.

Hemoptysis is a common and challenging clinical emergency, frequently secondary to high-prevalence diseases in China-such as pulmonary tuberculosis, bronchiectasis, lung cancer, and pulmonary mycosis-as well as respiratory interventional procedures. Patients with life-threatening massive hemoptysis can succumb to asphyxia or hemorrhagic shock within minutes. Currently, clinical practices in hemoptysis management across China exhibit significant disparities among different regions and hospital tiers, characterized by an overall deficit in rescue capabilities and high rates of mortality and disability. The establishment of hemoptysis centers, drawing on the experience of chest pain centers and stroke centers, has become imperative. Several hospitals across various provinces and municipalities in China have already established Hemoptysis Centers, yielding favorable clinical outcomes, and an increasing number of hospitals nationwide are actively advancing the development of these centers. To ensure the standardized and orderly establishment of these centers, the Chinese Thoracic Society, the Chinese Antituberculosis Association, the Interventional Pulmonology Group of the Chinese Association of Chest Physicians, and the Hemoptysis Expert Committee of the Haemorrhage Professional Committee of the Chinese Research Hospital Association convened national experts in related fields to formulate these Expert Recommendations on the standardized established of hemoptysis centers. As the first consensus of their kind both domestically and internationally, these recommendations aim to standardize the establishment of Hemoptysis Centers, promote the development of a nationwide Hemoptysis Center network, improve the success rate of hemoptysis treatment, and reduce the mortality and disability rates of affected patients.

Bronchiectasis severity scores, through useful in disease progression, are inadequate for monitoring exacerbation treatment. Therefore, it is of interest to investigate the correlation between serum albumin, Platelet Lymphocyte Ratio (PLR) and Neutrophil Lymphocyte Ratio (NLR) with disease severity in exacerbated bronchiectasis patients. Serum albumin and NLR demonstrated significant correlation with disease severity, while PLR did not. Post-treatment, both markers showed improvement, indicating their role in treatment monitoring. Thus, we show NLR and serum albumin as reliable biomarkers for assessing severity and monitoring treatment response in bronchiectasis.

We aimed to compare the risks of developing new chronic respiratory conditions, or exacerbating existing ones in survivors of 20 common cancers vs. cancer-free individuals.

Post-tuberculosis lung disease (PTLD) is an increasingly recognized consequence of pulmonary tuberculosis (TB) disease, affecting millions of survivors worldwide and imposing substantial clinical, functional, and socioeconomic burdens. This narrative review synthesizes current evidence across epidemiology, definitions, clinical phenotypes, assessment, and management, with dedicated consideration of children and adolescents. PTLD is common: Studies report abnormal spirometry in ∼60% of TB survivors and persistent, activity-limiting dyspnea in a sizeable minority. Outcomes are generally worse in low- and middle-income settings. The 2019 international consensus definition-"evidence of chronic respiratory abnormality attributable at least in part to prior TB"-has catalyzed research and service development; a newer research definition proposes a structured, three-domain approach (symptoms, radiology, lung function) and introduces "post-TB lung abnormality" for single-domain findings. PTLD encompasses heterogeneous patterns, including fibrosis, cavitation with chronic pulmonary aspergillosis risk, bronchiectasis, airflow obstruction, tracheobronchial stenosis, pleural disease, vascular complications, and pulmonary hypertension. Assessment should integrate symptom review, exercise capacity, oximetry, spirometry (with Global Lung Initiative [GLI] reference standards), and context-appropriate imaging, alongside targeted microbiology and echocardiography where indicated. Evidence for disease-modifying therapy remains limited; however, pulmonary rehabilitation improves function and symptoms, and selected patients may benefit from inhaled bronchodilators or surgical interventions. A "treatable traits" framework-spanning pulmonary, extrapulmonary, and behavioral risk domains-offers a pragmatic, person-centered strategy while high-quality trials mature. In children, TB during critical periods of lung development confers lasting functional and growth impacts, underscoring the need for age-specific screening and follow-up. We outline key research priorities: embedding PTLD outcomes in TB trials, standardizing measurement, elucidating mechanisms, evaluating host-directed therapies, and integrating post-TB care into routine health services.