The CLEAR trial published in the New England Journal of Medicine examined the effect of hypertonic saline and carbocisteine in patients with non-cystic fibrosis bronchiectasis.[1][5] 288 patients with daily sputum production and frequent pulmonary exacerbations who received standard care were randomized.[1][3] Patients were assigned to groups: hypertonic solution, carbocisteine, a combination of both, or standard care alone.[1][4] Groups with versus without hypertonic solution and carbocisteine versus without were compared; the primary endpoint was the number of pulmonary exacerbations over 52 weeks.[1][5] There was a mean of 0.76 exacerbations (95% CI 0.58–0.95) with hypertonic solution versus 0.98 (95% CI 0.78–1.19) without (adjusted difference -0.25; 95% CI -0.57 to 0.07; P=0.12).[1][3] There were 0.86 exacerbations with carbocysteine versus 0.90 without it (adjusted difference -0.04; 95% CI -0.36 to 0.28; P=0.81).[1][3] Secondary outcomes such as quality of life, time to next exacerbation, and adverse events were similar in all groups; no treatment interactions were found.[1][5]