Opinion
Video
Common Causes of Bronchiectasis
Panelists discuss how evaluating potential causes of bronchiectasis is important despite many cases being idiopathic, as identifying treatable traits can lead to specific interventions, such as CFTR modulators for those with CF mutations or IgG supplementation.
Clinical Brief: Etiologic Evaluation and First-Line Treatment of Bronchiectasis
Main Discussion Topics
- Etiologic evaluation is important, though many cases remain idiopathic.
- Treatment follows both “one-size-fits-all” baseline approaches and targeted interventions based on identified causes.
- First-line treatments focus on airway clearance, hydration, and infection management.
Key Points for Physicians
- Universal approaches include:
- Airway clearance techniques
- Physical exercise/pulmonary rehabilitation
- Regular clinical follow-up
- Nutritional counseling
- Vaccinations
- Etiologic evaluation may identify treatable traits:
- CFTR mutations (potential for modulators)
- Low IgG (consider supplementation)
- Aspiration/reflux (specific management)
- Sinus disease (targeted treatment)
- Personalize approaches based on the patient’s specific presentation and underlying etiology.
Notable Insights
In approximately 40% to 50% of cases, etiologic evaluation can identify host susceptibility factors that allow for targeted interventions beyond general management.
Clinical Significance
Combining universal bronchiectasis management approaches with etiology-specific interventions creates a more effective personalized treatment strategy.
