Evidence map›Paper›PMID 41299471›Full record

SynthesisRespiratory research2025

Efficacy and safety of DPP-1 inhibitors in bronchiectasis: a GRADE-assessed meta-analysis of randomized controlled trials.

Ahmed Emara, Ameer Awashra, Mohamed Ellebedy, Omar F Abbas, Ahmed Diaa, Mohamed S Elgendy, Mohamed Emara, Abdalhakim Shubietah, Abdul Muhsen Z Abdeen, Fadi Safi

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ahmed EmaraFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ameer AwashraDepartment of Internal Medicine, An-Najah National University, Rafidia Street, Nablus, West Bank, P606, Nablus, Palestine. ameer.awashra7@gmail.com.
Mohamed EllebedyFaculty of Medicine, Sohag University, Sohag, Egypt.
Omar F AbbasFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed DiaaFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed S ElgendyFaculty of Medicine, Tanta University, Tanta, Egypt.
Mohamed EmaraFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Abdalhakim ShubietahDepartment of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
Abdul Muhsen Z AbdeenDepartment of Pulmonary and Critical Care Medicine, Joan C. Edwards School of Medicine, Marshall University, 1600 Medical Center Drive, Huntington, WV, 25701, USA.
Fadi SafiDepartment of Pulmonary and Critical Care Medicine, University of Toledo, Toledo, OH, 43606, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBronchiectasis is a chronic inflammatory airway disease characterized by frequent exacerbations and neutrophilic inflammation. Dipeptidyl peptidase-1 (DPP-1) inhibitors block neutrophil serine protease activation and represent a promising therapeutic approach. This meta-analysis aimed to evaluate the efficacy and safety of DPP-1 inhibitors in adults with bronchiectasis.

methodsWe systematically searched PubMed, Scopus, Web of Science, and Cochrane Central up to July 2025 for randomized controlled trials (RCTs) comparing DPP-1 inhibitors with placebo. Outcomes were pooled as risk ratios (RRs) or hazard ratio (HR) or mean differences (MDs) with 95% confidence intervals (CIs). PROSPERO ID: CRD420251116443.

resultsFour RCTs (n = 2,523 patients) were included. DPP-1 inhibitors significantly reduced the risk of having one exacerbation (RR 0.64; 95% CI: 0.52-0.78; P < 0.0001), severe exacerbations (RR 0.44; 95% CI: 0.21-0.92; P = 0.03), and increased the proportion of patients who remained exacerbation-free during treatment (RR 1.33; 95% CI: 1.13-1.57; P = 0.0008). Time to first exacerbation was delayed (HR 0.66; 95% CI: 0.50-0.88; P = 0.004). There was a significant improvement in respiratory symptom scores (MD 2.80; 95% CI: 1.10-4.50; P = 0.001), but no difference in FEV₁ post-bronchodilator or rates of 2 or ≥ 3 exacerbations (P > 0.05). DPP-1 inhibitors significantly reduced severe and serious adverse events without increasing overall adverse events, treatment discontinuations, or mortality.

conclusionDPP-1 inhibitors reduce exacerbation frequency, delay time to first exacerbation, and improve respiratory symptoms in bronchiectasis without compromising safety. These findings support their role as a potential disease-modifying therapy in bronchiectasis management. Further long-term studies are warranted to confirm their sustained clinical benefit.

Indexed as

BronchiectasisDipeptidyl-Peptidase IV InhibitorsRandomized Controlled Trials as TopicHumansTreatment OutcomeDipeptidyl-Peptidase IV InhibitorsBrensocatibBronchiectasisDPP-1 inhibitorExacerbationGRADEMeta-analysisNeutrophil elastaseRandomized controlled trials

Identifiers

PMID41299471
PMCPMC12659227

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.