Drug trial offers hope to 200,000 people with ‘hidden’ lung condition

A multi-million-pound clinical trial, funded by LifeArc, to find out whether existing drugs could be used to treat people with a debilitating lung disease called Bronchiectasis will start next month.

The ‘hidden’ disease

Despite being the third most common lung condition in the UK, bronchiectasis is sometimes considered to be a ‘hidden’ disease due to a lack of public awareness, investment and research. The disease occurs when tubes in the lungs, called bronchi, become permanently damaged and widened, resulting in persistent breathing difficulties and repeated lung infections. The condition affects 1 in 200 people in the UK (approximately 200,000) but numbers are increasing due to an aging population. In the past decade, bronchiectasis cases have increased by 40% and they are expected to grow globally by a further 20% over the next 10 years. Despite this, there is no specific treatment or cure.

Researchers now hope to change that by exploring whether three existing anti-inflammatory drugs could be repurposed to treat bronchiectasis. The AIRNET (Anti-Inflammatory Repurposing Network) project is being run by researchers from EMBARC, a European Research Network for bronchiectasis, and the trial will be led by Professor James Chalmers at the University of Dundee. Patients across the UK will receive one of the three drugs. Over the course of a month, they’ll be monitored at one of several trial sites across the UK to see whether the drug has reduced their lung inflammation.

“This research will make a major contribution to the development of new anti-inflammatory treatments for bronchiectasis. Our future vision is that bronchiectasis will one day be managed with daily tablets or inhalers which control inflammation in the lungs, reducing flare-ups and symptoms, without the need to use antibiotics so frequently. This will help to improve quality of life for people with bronchiectasis as well as reducing antibiotic resistance.”
James Chalmers, Professor of Respiratory Medicine at the University of Dundee

The trial is supported by LifeArc as part of the Chronic Respiratory Infection Translational Challenge, dedicated to progressing new medical discoveries that will improve the lives of patients with bronchiectasis and cystic fibrosis.

“Bronchiectasis is a relatively poorly understood and under-diagnosed condition. It can be life-limiting and the day-to-day impact on people living with the disease, along with the economic impact on the NHS, can be significant. Repurposing existing drugs would allow us to get treatments to patients more quickly by reducing the time and costs associated with bringing new drugs to market. If successful, we hope that this trial could improve the lives of thousands of patients living with chronic lung diseases.”
Dr Catherine Kettleborough, Head of Chronic Respiratory Infection at LifeArc

Gaynor Hardman from Manchester was diagnosed with bronchiectasis when she was 61. With limited knowledge and understanding of the condition, she was not informed about what her diagnosis would entail.

“I was hospitalised because I had severe shortness of breath,” Gaynor says. “I thought my world was ending and that I was going to pass away right then and there because I had never experienced anything like it – it was such a scary experience. I hadn’t been told much about the breathlessness; I was just under the impression I would have a persistent cough. Because I wasn’t aware, this experience was even scarier.

“Following the treatment I received during my hospitalisation, I began to get a much better understanding of my condition. The hospital staff were very thorough and explicit, explaining exactly what to expect and how to manage daily with physio, chest clearance exercises, and regular medications.”

Gaynor adds: “This new trial gives me real hope that, one day, the condition will be more easily treatable and that patients like me will have a better quality of life, without needing specific daily exercises or limiting the activities we can do.”

Image of Gaynor Harman smiling — Gaynor Hardman was diagnosed with bronchiectasis at the age of 61.

Lessons from the pandemic

Professor Chalmers, who was heavily involved in studying the effect of Covid-19 on the respiratory system during the pandemic, adds that lessons learned from that time will influence this study:

“We have learned so much about trials from our work on Covid-19,” he explains. “We now have lab scientists integrated with the clinical team. This means that if we can see that a drug is not working at an early stage, then we can end that trial and move on, saving both time and money.

“Covid also taught us to adopt platform trials, allowing us to trial multiple drugs at the same time, which is far more efficient.

“While a torrid time, the pandemic has allowed us to reassess how we conduct clinical trials, which will significantly benefit us in new studies like this.”

In addition to testing three repurposed drugs, the AIRNET trial will also develop new laboratory tests for studying anti-inflammatory treatments for bronchiectasis. This will improve the efficiency of testing in future trials and continue to build on the capability of research centres in the UK.

The trial is due to start in September and initial results are expected to be published within 18 months – much faster than conventional trials because of the efficient trial design.