So with this background of an understanding of the pathophysiology and also the clinical trial results, the question now is which patients are likely to benefit from treatment with renzakaib. Uh, I think it's important to start with who are the patients who benefited in the trial. These are trials that have been conducted in patients with frequent exacerbations, with CT confirmed bronchiectis, who are highly symptomatic. Um, and those would be the patients that I'm most likely to prescribe these drugs to. The primary benefits of forensicib are reducing the risk of exacerbation and preventing disease progression. So, like any clinical situation, we can extrapolate that to who are the patients most likely to benefit. They're gonna be the patients at highest risk of exacerbation and who are at highest risk of disease progression. That encompasses a very large proportion of our patients, or certainly a large proportion of the patients that I see in my specialist clinic, um, so I think every patient that we see with bronchiectis, we should be evaluating, What is their risk of future exacerbations, that can be done with their history of prior exacerbations, but also how severely symptomatic are they, what other risk factors do they have for disease progression like pseudomonas infection, um, what is the trajectory of their lung function, we need to do lung function more often in our bronchiectis patients and identify patients whose lung function is declining rapidly, now that we have a drug that can prevent that rapid decline. Um, and so those are the factors I think I would take into account when thinking about the use of this drug. The subgroup data from the trials tells us that almost every subgroup of patients with bronchiexis can benefit from these medicines. So it's. Really just about the magnitude of that benefit and our threshold for prescribing, so that comes down to this, this point about every patient that you see, ask yourself those two questions. How likely is this person to have further exacerbations next year? You know, what sort of trajectory are they on? Are they a rapid decliner? The answer to those questions is either they're high risk or they're progressing, then I think they're a very good candidate for Brenza Khatib, and they're somebody that we need to be actively managing, uh, in a. way, remembering that brensicib's not the only treatment for bronchiectis and we need to also take that holistic view of treating the underlying causes, optimizing airway clearance in addition to doing uh the, the new disease modifying therapies.
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