Evidence map›Paper›PMID 42342264›Full record

SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2026

Mucoactive agents in bronchiectasis: a systematic review and meta-analysis.

Benjamin McCullough, John Busby, Brenda O'Neill, Bronwen Connolly, Rebecca H McLeese, Dermot Linden, Daniel F McAuley, J Stuart Elborn, Anthony De Soyza, James D Chalmers and 2 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2026. 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

12 authors.

Benjamin McCulloughWellcome Trust-Wolfson Northern Ireland Clinical Research Facility, Queen's University Belfast, Belfast, UK.ORCID https://orcid.org/0009-0004-8871-4805
John BusbyCentre for Public Health, Queen's University Belfast, Belfast, UK.
Brenda O'NeillInstitute of Nursing and Health Research, Ulster University, Belfast, UK.
Bronwen ConnollyWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.
Rebecca H McLeeseWellcome Trust-Wolfson Northern Ireland Clinical Research Facility, Queen's University Belfast, Belfast, UK.ORCID https://orcid.org/0000-0003-0647-2503
Dermot LindenWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.
Daniel F McAuleyWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.ORCID https://orcid.org/0000-0002-3283-1947
J Stuart ElbornWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.
Anthony De SoyzaPopulation Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.ORCID https://orcid.org/0000-0002-8566-0344
James D ChalmersScottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
Mike ClarkeCentre for Public Health, Queen's University Belfast, Belfast, UK.
Judy M BradleyWellcome Trust-Wolfson Northern Ireland Clinical Research Facility, Queen's University Belfast, Belfast, UK judy.bradley@qub.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMucoactive agents aim to improve mucociliary clearance in bronchiectasis, disrupting the cycle of impaired clearance, infection and inflammation. Registry data show 28% of patients use these agents, but prescribing varies due to limited evidence. We aimed to update evidence on mucoactive agents' effects in adults with bronchiectasis.

methodsWe conducted a systematic review and meta-analysis, searching Medline, Embase, CENTRAL and trial registries to 1 October 2025. Eligible studies included adults with bronchiectasis, evaluating any mucoactive agent

findingsFrom 1512 records, 24 studies (20 randomised, four observational: n=7051) evaluated eight mucoactive agents (ambroxol, bromhexine, carbocisteine, erdosteine, hypertonic saline, mannitol, N-acetylcysteine, rhDNase). Most trials had high or some risk of bias. Seven randomised studies (n=1259) reported exacerbations; pooled analysis did not demonstrate a statistically significant difference in annualised exacerbation incidence (mean difference -0.40 per patient per year, 95% CI -1.04-0.24; p=0.22; I

interpretationPooled evidence did not show a reduction in exacerbations and FEV

Indexed as

BronchiectasisExpectorantsLungMucociliary ClearanceAdultDisease ProgressionHumansQuality of LifeRecovery of FunctionTreatment OutcomeExpectorants

Identifiers

PMID42342264
PMCPMC13291835

What OpenQuestion holds

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Registered trials

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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.