Brensocatib in Bronchiectasis — A New Sheriff in Town

This editorial analyzes findings from the ASPEN trial evaluating brensocatib, a dipeptidyl peptidase 1 (DPP-1) inhibitor, as a treatment for bronchiectasis. Involving over 1,700 participants across 35 countries, the trial showed that brensocatib significantly reduced pulmonary exacerbation rates compared to placebo and was generally well tolerated. The editorial explores the drug’s mechanism targeting neutrophil-driven inflammation and contextualizes its potential as an alternative to long-term antibiotics like macrolides. While not a definitive replacement, brensocatib is positioned as a welcome new option, especially for patients with milder disease or those who cannot tolerate current standard therapies. Further studies are encouraged to better define its role across patient phenotypes and treatment stages.

This editorial analyzes findings from the ASPEN trial evaluating brensocatib, a dipeptidyl peptidase 1 (DPP-1) inhibitor, as a treatment for bronchiectasis. Involving over 1,700 participants across 35 countries, the trial showed that brensocatib significantly reduced pulmonary exacerbation rates compared to placebo and was generally well tolerated. The editorial explores the drug’s mechanism targeting neutrophil-driven inflammation and contextualizes its potential as an alternative to long-term antibiotics like macrolides. While not a definitive replacement, brensocatib is positioned as a welcome new option, especially for patients with milder disease or those who cannot tolerate current standard therapies. Further studies are encouraged to better define its role across patient phenotypes and treatment stages.