CLEAR Trial Hosted at NICRF Delivers Practice-Changing Findings for Bronchiectasis Treatment
A major UK clinical trial hosted at the Northern Ireland Clinical Research Facility (NICRF) and led by Professor Judy Bradley, Lead Physiotherapy Investigator and CEO of iREACH Health, has delivered significant findings that challenge current treatment practices and carry major implications for clinical guidelines and healthcare policy.
Funded by the National Institute for Health and Care Research (NIHR), the CLEAR trial is the largest UK study to date investigating treatments for non-cystic fibrosis bronchiectasis. Conducted across 20 NHS sites and involving 288 participants, the trial evaluated the effectiveness of two commonly prescribed mucus-clearing therapies: hypertonic saline (HTS) and carbocisteine.
Over a 52-week period, the study found that neither HTS nor carbocisteine significantly reduced pulmonary exacerbations or improved other key outcomes such as lung function, quality of life, or antibiotic use. While both treatments were safe, they provided no measurable clinical benefit.
Implications for Policy and Practice
- Guideline Clarity: The use of mucoactive therapies varies widely across the UK due to inconsistent recommendations. CLEAR provides robust evidence to support a more consistent, evidence-based approach.
- Resource Reallocation: Findings suggest healthcare resources should be redirected toward more effective strategies for managing bronchiectasis and improving patient outcomes.
- Evidence-Based Prescribing: The trial empowers clinicians and policymakers to make informed decisions based on high-quality, UK-led research.
Professor Judy Bradley
Lead Investigator, CLEAR Trial | CEO, iREACH Health
“Our findings show there is no benefit in prescribing hypertonic saline or carbocisteine to prevent exacerbations in people with bronchiectasis. This provides clarity for patients, clinicians and policymakers and should inform future guideline updates.”
Hosted in Northern Ireland, Driving National Impact
The success of the CLEAR trial highlights the capacity of NICRF @iREACH Health to host high-impact, multi-site research and demonstrates the leadership of Northern Ireland in delivering practice-changing clinical evidence.
Through the strategic infrastructure of iREACH Health, Northern Ireland is uniquely positioned to:
- Deliver clinical research aligned with healthcare priority areas
- Translate research into real-world improvements in population health
- Drive economic impact through innovation and evidence-based care
- Promote inclusion, diversity, and well-being across underserved communities
iREACH Health’s integrated model ensures that research findings like those from CLEAR are translated into policy, practice, and service delivery, fully realising the potential of research to change lives across Northern Ireland and beyond.