Introduction: Non-CF bronchiectasis is a chronic disease with limited treatment options. We conducted a meta-analysis to compare the efficacy and safety of mannitol and hypertonic saline (HS).

Methods: We searched multiple databases for RCTs comparing the effects of mannitol and HS on non-CF bronchiectasis. Meta-analysis was performed with RevMan and network meta-analysis with R.

Results: Our study included 9 RCTs with 1,066 patients. Mannitol showed no statistical difference in FEV1 improvement and mucous clearance compared to placebo. HS, on the other hand, significantly improved FEV1 and mucous clearance. Both treatments improved physical activity. In the network meta-analysis, HS showed significant improvements in FEV1 compared to both placebo and mannitol. (Fig. 1 and 2)

Conclusion: HS is more effective than mannitol in improving FEV1 and mucous clearance in non-CF bronchiectasis. Both treatments, however, showed significant improvements in physical activity.