From the Research
Yes, in the ASPEN trial, brensocatib was associated with a lower annualized rate of exacerbations than placebo in patients with bronchiectasis. The trial demonstrated that brensocatib, a DPP-1 (dipeptidyl peptidase-1) inhibitor, at doses of 10 mg and 25 mg once daily, significantly reduced the rate of pulmonary exacerbations compared to placebo over a 52-week treatment period, with a rate ratio of 0.79 [95% confidence interval {CI}, 0.68 to 0.92; adjusted P = 0.004] with the 10-mg dose and 0.81 [95% CI, 0.69 to 0.94; adjusted P = 0.005] with the 25-mg dose 1. Brensocatib works by inhibiting neutrophil serine proteases, which are involved in the inflammatory process in bronchiectasis. By reducing neutrophil activity, brensocatib helps decrease airway inflammation and tissue damage, potentially improving outcomes in bronchiectasis patients who suffer from recurrent exacerbations. Some key points to consider when using brensocatib in bronchiectasis patients include:
- The annualized rate of pulmonary exacerbations was 1.02 in the 10-mg brensocatib group, 1.04 in the 25-mg brensocatib group, and 1.29 in the placebo group 1
- The hazard ratio for the time to the first exacerbation was 0.81 (95% CI, 0.70 to 0.95; adjusted P = 0.02) with the 10-mg dose and 0.83 (95% CI, 0.70 to 0.97; adjusted P = 0.04) with the 25-mg dose 1
- Brensocatib also exerts broad anti-inflammatory effects beyond its known effects on serine proteases, including increasing antimicrobial peptides and reducing mucin-5AC 2 However, it's essential to note that the drug was also associated with an increased risk of dental and skin adverse events, and the FDA has not yet approved brensocatib for clinical use in bronchiectasis, as further evaluation of its benefit-risk profile is needed.