If you’re living with bronchiectasis, you’re likely familiar with the exhausting cycle of thick mucus, chronic coughing , and fear of the next flare-up. For years, treatment has focused on managing symptoms: clearing mucus and fighting infections after they start. A new treatment has changed the landscape. Since 2025, when the U.S. Food and Drug Administration (FDA) approved the medication brensocatib (Brinsupri), treatment can now target the underlying inflammation that contributes to non-cystic fibrosis bronchiectasis, not just the symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291983ee59-d939-453d-be7e-47be443316be Knowing how the drug works and its side effects can help you and your care team find the right treatment for your chronic lung condition.
How It Works Brensocatib Targets Inflammation Brensocatib works by reducing the drivers of the inflammation that damages airways and causes mucus buildup, says Amit “Bobby” Mahajan, MD, a national medical spokesperson for the American Lung Association and the system chief of interventional pulmonology at Inova Health System in Vienna, Virginia. When bacteria get into your lungs, your body sends out infection-fighting cells called neutrophils. These cells help kill germs and protect you. But with bronchiectasis, this response can go into overdrive. Neutrophils release powerful enzymes called neutrophil serine proteases to fight infection. Over time, those enzymes can start to harm healthy lung tissue, too.e60dc2a1-f33c-4a05-9b50-8e3e8e59762975fdee1d-f61b-480e-9c3c-d429f6b8297a Brensocatib disrupts that process by blocking an enzyme called DPP1 that helps switch on those damaging enzymes while neutrophils are still developing in your bone marrow. By turning down that activation step, the medication helps limit how much injury neutrophils can cause once they reach the lungs.e60dc2a1-f33c-4a05-9b50-8e3e8e59762955682f72-4740-42bb-8ceb-d0d419948818 This can mean less inflammation, less airway damage, and an easier time clearing mucus, Dr. Mahajan says. “As a result, people are more functional, are feeling better, and are more active,” he says. By reducing flare-ups, called exacerbations, brensocatib can also preserve lung function longer term, says Panagis Galiatsatos, MD, a national spokesperson for the American Lung Association and an assistant professor at the Johns Hopkins School of Medicine in Baltimore. “You want to reduce these exacerbations because they are a burden to a patient,” he says. “[Brensocatib] won’t fully reverse the bronchiectasis, but it’ll keep it from being symptomatic.”
Supporting Data The Data The FDA evaluated positive results from two trials examining how brensocatib can treat bronchiectasis. In the phase 2 WILLOW study, people taking 10 or 25 milligrams (mg) of brensocatib over 24 weeks reduced their risk of flare-ups by 38 to 42 percent. The medication also helped to extend the time between flare-ups and reduced neutrophil activity.e60dc2a1-f33c-4a05-9b50-8e3e8e597629140701b3-909a-47d2-8c0f-12fe8a40b669 The larger phase 3 ASPEN trial found a 20 percent reduction in annual flare-ups over 52 weeks for people taking 10 and 25 mg doses. Both doses also extended the time to the first flare-up and increased the likelihood of remaining flare-up-free. People on the 25 mg dose also showed less decline in lung function, measured by forced expiratory volume, the amount of air you can force out in one second.e60dc2a1-f33c-4a05-9b50-8e3e8e59762955682f72-4740-42bb-8ceb-d0d419948818
Using Brensocatib How to Use Brensocatib Brensocatib isn’t a replacement for your current bronchiectasis treatment, and you’ll need to continue the daily rituals you already practice to keep your airways clear. The new drug should be used in addition to other treatments, such as postural draining, chest percussion therapy, inhaled therapies, and exercise.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290bf9736b-428c-4daf-8cf8-ce6854ebd46f Brensocatib helps calm inflammation, but it doesn’t clear mucus on its own. “Depending on the cause of your bronchiectasis, [brensocatib can] be used along with airway clearance and also sometimes still needing pulmonary rehabilitation or surgery,” Mahajan says. How long you’ll take it depends on your situation. Most people who take brensocatib do so regularly, Mahajan says. Your doctor can work with you on dosage and how long you will need to take it, based on your symptoms and quality-of-life goals.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f4ac4ad1-157e-45da-976e-000c9d824619 Because brensocatib works by lowering part of your immune response, a few extra precautions are important while you’re taking it. Talk to your doctor before getting any new vaccines. Your doctor may recommend not getting live attenuated vaccines, such as those for measles or the flu , to avoid interactions.e60dc2a1-f33c-4a05-9b50-8e3e8e597629723c27f3-048c-433c-9bb7-7a6fc9b3c0b4 Dr. Galiatsatos also stresses “appropriate infectious control,” such as wearing a mask during high viral seasons, washing your hands often, and avoiding close contact with people who are sick. These simple steps can help lower your risk of infections that could trigger a flare.
Dosage Dosage and Administration Brensocatib is a once-daily, oral pill, available in 10 and 25 mg doses. You can take it with or without food at any time of the day, but ideally at the same time each day.e60dc2a1-f33c-4a05-9b50-8e3e8e597629723c27f3-048c-433c-9bb7-7a6fc9b3c0b4
Side Effects Side Effects and Warnings The most common side effects include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f4ac4ad1-157e-45da-976e-000c9d824619 Upper respiratory tract infections Headache Skin issues and rashes Dry or thickening skin, or hyperkeratosis High blood pressure , hypertension Gum or dental problems Galiatsatos says nausea and gastrointestinal issues are also common, though the newness of the medication means that we might not know all side effects yet. Brensocatib side effects occur more often in people taking the 25 mg dose than in those taking the 10 mg dose.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e639a9a6-104e-414c-b6c9-124958ddced2 Less common side effects include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f4ac4ad1-157e-45da-976e-000c9d824619 Hair loss (alopecia) Abnormal liver blood tests, indicating potential liver irritation or stress Skin cancer Galiatsatos also advises people taking brensocatib to have dental checkups every six months because the drug’s effect on tissue enzymes may increase your risk of gum disease . Live attenuated vaccines also are not recommended while taking brensocatib. Be sure to talk to your doctor about your existing health conditions and vaccine status before starting brensocatib.e60dc2a1-f33c-4a05-9b50-8e3e8e597629723c27f3-048c-433c-9bb7-7a6fc9b3c0b4 The Takeaway Brensocatib (Brinsupri) is the first medication to target the underlying inflammation contributing to bronchiectasis, rather than treating symptoms after they start. Brensocatib can reduce the number of flare-ups of the chronic lung condition and increase the time between them, potentially slowing down the decline of lung function. The medication is available as a daily pill in 10 or 25 mg doses, depending on what your doctor prescribes, and is used in addition to traditional bronchiectasis treatments such as daily airway clearance techniques.
Resources We Trust Mayo Clinic: Brensocatib (Oral Route)American Journal of Managed Care: Guidelines for Bronchiectasis Highlight Multiple Treatment MethodsAmerican Lung Association: Treating and Managing BronchiectasisCleveland Clinic: BronchiectasisEuropean Lung Foundation: Bronchiectasis Self-Care Guide
Great Job Susan Jara & the Team @ google-discover for sharing this story.
