Breathing Easier: Brensocatib’s Promise in Bronchiectasis
What is Bronchiectasis?
Bronchiectasis (pronunciation: bron-ki-ek-tas-is) is a chronic lung disease
characterized by the permanent dilation or widening of airways (tubes carrying air to
the lungs) and impaired clearance of mucus. A thin layer of mucus is required to trap
inhaled foreign particles, but excessive mucus can promote bacterial growth, leading
to recurrent infections and further damage to the airways.
Bronchiectasis is broadly divided into two categories: cystic fibrosis (CF) and non-
cystic fibrosis bronchiectasis. CF is a genetic condition where thick mucus is
produced in various organs of the body. Non-cystic fibrosis bronchiectasis results
from recurrent airway infections, autoimmune diseases, or inherited airway
diseases.
Symptoms of bronchiectasis
Recurrent infections with fever, cough, cold
Productive cough with phlegm/mucus
Shortness of breath or wheezing
Blood in mucus
Management of Non-Cystic Fibrosis Bronchiectasis
Hydration
Expectorants and mucolytics (help break up mucus or phlegm)
Avoid toxic fumes
Chest physical therapy and medical devices that help break up and bring out the phlegm
Antibiotics for infections
Brensocatib
Brensocatib
Brensocatib is the first FDA-approved medication for the treatment of non-cystic
fibrosis bronchiectasis in adults and children of age ≥12 years (2).
Mechanism of Action
Immune cells (for example, neutrophils) and the enzymes they release are
responsible for fighting infections. Sometimes, the excessive release of enzymes can
be counter-productive and result in persistent inflammation or activity. This can
damage the airways and prolong flare-ups (exacerbations) of bronchiectasis.
Brensocatib can selectively inhibit an enzyme involved in this vicious cycle and help
reduce flare-ups (3, 4).
It was tested in the WILLOW and ASPEN clinical trials and was found to have better
clinical outcomes and reduction in the time to a flare-up in non-cystic fibrosis
bronchiectasis (3, 4).
Dosage
10 mg or 25 mg orally with or without food.
If a dose is accidentally missed, the next dose should be taken at the regular time and double dosing should be avoided.
Side effects
Skin reactions: dry skin, rash, small areas of skin thickening (hyperkeratosis)
Dental problems
Headache
Upper respiratory tract infection
Less common side effects:
High blood pressure
Abnormal liver function tests on bloodwork
Hair loss (alopecia) and skin cancers
Avoid live vaccines with brensocatib
Precautions
Not for pregnant women or those who are planning to get pregnant.
Not for women who are breastfeeding or planning to breastfeed.
Not for children younger than 12 years of age.
Avoid its use with administration of live attenuated vaccines.
Follow up with a dentist or skin doctor for monitoring of dental or skin side
effects.
Conclusion
Brensocatib is the first FDA approved medication for the treatment of non-cystic
fibrosis bronchiectasis in adults and children ≥12 years of age. The most common
side effects are skin and dental problems. Avoid in women who are pregnant or
breastfeeding. Avoid administering live attenuated vaccines with Brensocatib.
References
1. Saint John's Cancer Institute. Bronchiectasis [Internet]. Santa Monica (CA):
Saint John's Cancer Institute; [cited 2026 Jul 20]. Available
(Source for image)
2. U.S. Food and Drug Administration. BRINSUPRI (brensocatib) tablets, for oral
use: prescribing information[Internet]. Silver Spring (MD): U.S. Food and Drug
Administration; 2025 Aug [cited 2026 Jul 20]. Available
0lbl.pdf.
3. Chalmers JD, Haworth CS, Metersky ML, Loebinger MR, Blasi F, Sibila O, et
al. Phase 2 trial of the DPP-1 inhibitor brensocatib in bronchiectasis. N Engl J
Med. 2020;383(22):2127-2137. doi:10.1056/NEJMoa2021713.
4. Chalmers JD, Burgel PR, Daley CL, De Soyza A, Haworth CS, Mauger D, et
al. Phase 3 trial of the DPP-1 inhibitor brensocatib in bronchiectasis. N Engl J
Med. 2025;392(16):1569-1581. doi:10.1056/NEJMoa2411664.
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