BronchiEctasis Trial Testing ERdosteine (BETTER)

Bronchiectasis is a chronic lung disease in which the airways become permanently damaged and widened, making it hard to clear mucus and leading to repeated chest infections. It is particularly challenging for children and young people, where evidence-based treatments remain limited. The BETTER trial is testing a medication called erdosteine, which has several potentially beneficial effects: it helps thin and clear mucus, reduces inflammation in the airways, has antioxidant properties, and may even make it harder for bacteria to stick to the airway walls. This trial is open to people aged 2 to 49 years with bronchiectasis who have had at least two chest exacerbations in the past 18 months. Participants will take either erdosteine or a placebo for 12 months, and the study will measure whether the medication reduces the number of chest infections and improves quality of life. Participants will be followed up for 15 months in total. People with cystic fibrosis, significant liver or kidney disease, or those who are pregnant or planning pregnancy are not eligible. This study is particularly important because there are very few proven treatments for non-cystic fibrosis bronchiectasis in children, and it also includes a cost-effectiveness analysis to determine value for money.