1. In adults with noncystic fibrosis bronchiectasis, hypertonic saline and carbocisteine did not significantly reduce pulmonary exacerbations or improve quality of life versus standard care.
2. The CLEAR trial enrolled 288 patients across 20 UK hospitals and followed them for 52 weeks using an open-label randomized design.
3. Secondary outcomes—including lung function, antibiotic use, and time to next exacerbation—showed no meaningful differences across treatment arms.
4. Adverse events were comparable among groups, though mild gastrointestinal effects were more frequent with carbocisteine.
5. Researchers recommend reconsidering mucoactive therapy in bronchiectasis management due to limited efficacy and additional treatment burden.

Source: The New England Journal of Medicine