Bronchiectasis has long been a debilitating and underdiagnosed chronic lung disease. It’s a condition where inflammatory processes lead to widening of the airways, mucus buildup and increased susceptibility to recurrent infections. One of the most common causes of infection is nontuberculous mycobacteria, referred to as NTM. These bacteria can also worsen bronchiectasis.

“Bronchiectasis is a less recognized disease and patients go undiagnosed or misdiagnosed for years,” says Montefiore Einstein pulmonologist Divya Reddy, MBBS, MPH. “It’s incredibly important that patients have access to experts in the field who offer high-quality, guideline-based care, and new treatment options through clinical trials.” Montefiore Einstein infectious diseases specialist Eric Meyerowitz, MD, adds, “Many patients have been bounced around between various providers for a long time and when they first see us, they feel terrible. They may have heard that treatment is impossible or difficult.” To help meet the needs of these patients, Montefiore Einstein founded its Bronchiectasis and NTM Disease program in 2021, directed by Dr. Reddy and co-directed by Dr. Meyerowitz.

In 2024, the Bronchiectasis and NTM Association, which advocates for patients and the development of new treatments, launched a special designation for healthcare institutions that are equipped to provide the highest standards of care. Part of the goal was to raise awareness of the condition and give patients access to proven expertise. 

In 2025, Montefiore Einstein became one of just eight institutions nationwide to join the Bronchiectasis and NTM Care Center Network at the highest level, along with Baylor College of Medicine, Yale University, and other top academic medical centers. Institutions earn the designation as part of a competitive application process and must demonstrate that they offer specialists in the treatment of bronchiectasis and NTM as part of an integrated and comprehensive multidisciplinary care model. Applications are judged by the Bronchiectasis and NTM Association.

Dr. Reddy and Dr. Meyerowitz or one of a few select colleagues in pulmonology and infectious diseases are the first physicians that patients with this diagnosis will see at Montefiore Einstein. But perhaps the top reason we earned the Care Center Network distinction is the other specialty care we offer within our system, including thoracic surgery, gastroenterology, allergy and immunology, otolaryngology (ENT), respiratory therapy, pulmonary rehabilitation, nutrition, and more. 

“In treating these patients, you can't do it alone,” says Dr. Meyerowitz. “Even if you're the best pulmonologist or infectious disease doctor, you really do need a whole team. That's what the Bronchiectasis and NTM Association is trying to recognize and encourage with the Care Center Network.”

A growing need

In 2024, Montefiore Einstein’s program saw 185 patients with bronchiectasis. In 2025, it is on track to see 300. “It's said to be uncommon, but there is really good data that it's being recognized more and more as our diagnostics get better,” says Dr. Reddy. 

For patients with NTM, climate change is partly driving this increase. The bacteria are widely present in soil and water, as well as inside the home in places like showerheads, and in swimming pools and saunas. While the bacteria don’t pose a risk for people with a healthy immune system, as our planet warms, they are thriving in more places, increasing the chances of exposure for those who are vulnerable. “Because of improvements in care, people with chronic lung diseases are fortunately living longer as well,” adds Dr. Meyerowitz. “This means that along with more bacteria, there's an increased population that’s susceptible.”

To meet the growing need and rapid expansion of the program, in addition to Dr. Reddy, who sees patients at Montefiore’s Hutchinson campus, and Dr. Meyerowitz, who sees patients at the Oval Center and the Family Care Center, near Montefiore’s Moses Hospital, pulmonologists Jay Dobkin, MD, and Rivkah Darabaner, MD, have also recently begun seeing patients as part of the program.

Access to a wide range of expert care

One of the requirements to become part of the Care Center Network is a multidisciplinary case conference, which takes place every six weeks and is led by Dr. Reddy. “We discuss complex cases as a team, review images with chest radiologists and come up with a comprehensive treatment plan for the patient,” she explains. “With the thoracic surgery and lung transplant teams as part of the conference, decisions on the possibility of surgery and need for transplant evaluations can be made very quickly.” 

Surgery is an option when there is an infection in the lung that is resistant to antibiotics and other treatments. “Depending on the location of the infection within the lung, surgeons with special expertise can take out the infected area,” says Dr. Reddy. “This gives certain patients the best chance of having a favorable outcome.”

For patients with drug-resistant infections for whom removing a portion of the lung isn’t viable, the team connects them with Montefiore’s lung transplant surgeons for an evaluation. “It’s amazing that at Montefiore, we are able to offer this as an option for our patients,” says Dr. Meyerowitz. 

They also refer patients to an array of other specialists, all with expertise in bronchiectasis and NTM, depending on the patient’s individual needs. While in nearly half of cases, the exact cause of bronchiectasis is unknown, one contributing factor is gastroesophageal reflux disease, often known as GERD. Dr. Reddy and Dr. Meyerowitz refer patients with GERD symptoms to Daniel Behin, MD, in gastroenterology. They also collaborate closely with ENT specialist Nadeem Akbar, MD, for evaluation and management of patients with upper airway infections and chronic inflammation. 

“A lot of patients come in with failure to thrive,” adds Dr. Meyerowitz. “Their symptoms can cause loss of appetite and they become malnourished, which is a poor prognostic sign.” This is why there are also nutritionists who work with the team. Respiratory therapists help to assess breathing and lung function, and educate patients on how to effectively clear their airways. Patients whose respiratory symptoms have made it hard for them to be active are connected with pulmonary rehabilitation, which Montefiore offers in collaboration with Burke Rehabilitation.

‘An exciting time to be in this field’

There has never been an FDA–approved treatment for bronchiectasis. That changed this past August, when the FDA greenlit the use of a once-a-day anti-inflammatory medication, brensocatib, after an international clinical trial in over 1,700 patients. Known as the ASPEN clinical trial, it demonstrated that brensocatib reduced exacerbations and slowed loss of lung function over a 12-month period. Montefiore Einstein was a participating site, with Dr. Reddy serving as the site primary investigator. The results were published in the New England Journal of Medicine. 

“It's a very exciting time to be in this field,” she says. “It’s great knowing we have a proven tool to help patients and improve their quality of life. And there are now a number of clinical trials looking at new therapies for bronchiectasis and NTM.” 

Dr. Reddy is also the site primary investigator for the ENCORE trial, which is looking at inhaled amikacin as a potential treatment in cases of infection with Mycobacterium avium intracellulare, another common complication of bronchiectasis. Dr. Meyerowitz was the site primary investigator for a recent phase 2 clinical trial for people with Mycobacterium abscessus infection. “We were actually one of the highest enrolling sites in the country for a study of omadacycline, which is an oral antibiotic, for M abscessus. It was the first study to show benefit for this highly resistant and difficult-to-treat infection,” he says. Dr. Meyerowitz is also the site lead on a current trial of inhaled clofazimine. “Like amikacin, this is another medication that can be inhaled and we hope it will be another good option for our many of our patients,” he says. “Right now, the only way patients can access it is through this clinical trial.”

Adds Dr. Reddy, “Just in the last couple years we've had breakthrough treatment options. Thanks to the clinical trials, we were able to offer these to our patients before they were widely available. That’s another marker of a high-quality program.”

Dr. Reddy grew up in India and saw many patients with active tuberculosis during her medical training. “That really sparked my interest in pulmonary infections,” she shares. During her fellowship training, she did tuberculosis research in India and Africa. “When I decided to focus on education and clinical medicine,” she continues, “it was a natural transition to specialize in nontuberculous mycobacteria as a lung condition, because the prevalence is really growing in the U.S. The new treatments we’re starting to see now are inspiring and give us a lot of hope for the future.” 

“A lot has changed,” says Dr. Meyerowitz. “I've been at Montefiore Einstein now for almost five and a half years and some of my patients I've had the whole time. We get to know them really well. It’s very rewarding to help them manage what they may have been told is an impossible disease, and show them that's really not the case anymore.”