Brinsupri (brensocatib) / Insmed, AstraZeneca - LARVOL DELTA

Brensocatib in non-cystic fibrosis bronchiectasis: neutrophil serine protease modulation, clinical evidence, and therapeutic positioning. (PubMed, Expert Rev Clin Pharmacol) - "It should be integrated with airway-clearance and infection-directed management rather than viewed as a stand-alone intervention. Its long-term value will depend on appropriate patient selection, dermatologic and periodontal monitoring, affordability, comparative effectiveness, and real-world evidence on exacerbations, antibiotic use, lung-function trajectories, and patient-centered outcomes."

Journal • Review • Bronchiectasis • Genetic Disorders • Immunology • Infectious Disease • Inflammation • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

Cathepsin C promotes atherosclerosis by modulating neutrophil recruitment and neutrophil extracellular trap formation. (PubMed, Int Immunopharmacol) - "Cellular experiments involved co-culture of THP-1-derived foam cells with differentiated HL-60 neutrophils, employing the CTSC inhibitor AZD7986 for mechanistic studies...Our findings identify CTSC as an important regulator of neutrophil recruitment and NETosis in atherosclerosis and suggest its potential as a therapeutic target for plaque stabilization. Our findings identify CTSC as an important regulator of neutrophil recruitment and NETosis in atherosclerosis and suggest its potential as a therapeutic target for modulating atherosclerotic plaque pathology."

Journal • Atherosclerosis • Cardiovascular • Coronary Artery Disease • Heart Failure • Inflammation • APOE • CTSC • IL1B

Medical issues and pulmonary outcomes in cystic fibrosis and bronchiectasis. (PubMed, Curr Opin Pulm Med) - "Management of all forms of bronchiectasis is increasingly shifting toward individualized, endotype-directed care. Integration of disease-modifying therapies, systematic assessment of comorbidities, validated severity stratification tools, and patient-reported outcomes will be essential to optimizing long-term clinical outcomes and advancing precision medicine approaches across this heterogeneous disease spectrum."

Journal • Bronchiectasis • Cystic Fibrosis • Gastroenterology • Gastroesophageal Reflux Disease • Genetic Disorders • Immunology • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

Bronchiectasis in immunodeficiency. (PubMed, Curr Opin Pulm Med) - "This review highlights the need for ongoing research to improve detection of bronchiectasis in immunodeficiency and include patients with immunodeficiency and bronchiectasis in trial designs for therapeutics in bronchiectasis."

Journal • Bronchiectasis • Pulmonary Disease • Respiratory Diseases

The mechanisms and science underlying chronic childhood wet cough (ERS 2026) - "Inflammation. Importantly, inflammation is early, when the disease is active, which mandates trials of anti-inflammatory therapies (e.g. Brensocatib) in early, active disease, rather that waiting for the airway to be irretrievably damaged."

Clinical • Bronchiectasis • Cough • Infectious Disease • Inflammation • Pulmonary Disease • Respiratory Diseases

Targeting the roots: therapeutic innovation in the care of patients with cystic fibrosis and primary ciliary dyskinesia (ERS 2026) - "Additionally, novel dipeptidyl peptidase 1 inhibitors, including the recently approved brensocatib, have shown promise in reducing the harmful effects of neutrophilic inflammation in non-CF bronchiectasis...Furthermore, progress in genetic engineering and gene editing has paved the way for gene therapies that aim to directly repair the underlying DNA mutations in both CF and PCD, and thus offer the potential for a definitive cure. In contrast, other forms of bronchiectasis currently lack genome-, transcriptome- or proteome-level therapies that directly restore mucociliary clearance."

Clinical • Bronchiectasis • Cystic Fibrosis • Gene Therapies • Genetic Disorders • Immunology • Inflammation • Non‐Cystic Fibrosis Bronchiectasis • Otorhinolaryngology • Pulmonary Disease • Respiratory Diseases • CFTR

Brensocatib in patients with non-cystic fibrosis bronchiectasis (NCFB) and history of nontuberculous mycobacteria (NTM) infection: A post-hoc analysis of the ASPEN trial (ERS 2026) - "AEs were mostly similar across treatment arms; pts with NTM history had more AEs vs without. Consistent with overall results, regardless of NTM history, brensocatib showed benefits in PEx vs pbo."

Clinical • Nontuberculous mycobacteria • Retrospective data • Bronchiectasis • Genetic Disorders • Immunology • Infectious Disease • Non‐Cystic Fibrosis Bronchiectasis • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases

Brensocatib and Beyond: Integrating Novel Anti-Inflammatory Strategies in Non-CF Bronchiectasis (CHEST 2026) - No abstract available

Bronchiectasis • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

2025: Pardon the Disruption: Debating Evidence-Based Care in Bronchiectasis (CHEST 2026) - "Expert panelists will debate controversial and evolving management domains, including culture-guided empiric antibiotic selections, optimal treatment durations, and emerging long-term anti-inflammatory options like brensocatib...3. Design individualized airway clearance regimens using a multidisciplinary approach."

Bronchiectasis • Genetic Disorders • Immunology • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

The Impact of Brensocatib Approval on How to Design the Future Trials in Non-CF Bronchiectasis (CHEST 2026) - No abstract available

Bronchiectasis • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

1354: Challenges in Drug Development: The Brensocatib Example (CHEST 2026) - "4. Recognize recruitment and retention risks when an investigational drug becomes commercially available, and identify mitigation strategies."

1307: Non-CF Bronchiectasis Across the Lifespan: Progress, Updated Recommendations, and Emerging Therapies (CHEST 2026) - "3. Evaluate the role of emerging therapies including brensocatib and incorporate evidence-based approaches for integrating new treatments into bronchiectasis management in both adult and pediatric populations."

Bronchiectasis • Genetic Disorders • Immunology • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases • ELANE

Population Pharmacokinetic Analysis of Brensocatib in Adult and Adolescent Patients With Non-Cystic Fibrosis Bronchiectasis. (PubMed, CPT Pharmacometrics Syst Pharmacol) - P3 | "No identified covariates were clinically relevant. This analysis supported brensocatib dosage of 10 and 25 mg in patients with bronchiectasis ≥ 12 years without dose adjustment."

Journal • PK/PD data • Bronchiectasis • Genetic Disorders • Hepatology • Immunology • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Renal Disease • Respiratory Diseases

Brensocatib in cystic fibrosis: Early experience from a single center (NACFC 2026) - "In this ongoing exploratory real-world analysis, brensocatib was associated with a possible reduction in pulmonary exacerbations in pwCF, although no clear benefit in lung function was observed. Brensocatib was initiated off-label in this cohort due to frequent exacerbations, advanced lung disease, or ineligibility for highly effective CFTR modulator therapy. Interpretation is limited by the small sample size and short follow-up duration, which may underestimate true exacerbation rates."

Clinical • Bronchiectasis • Cystic Fibrosis • Genetic Disorders • Immunology • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases • CFTR

Non-CF bronchiectasis induces similar pathological programming airway neutrophil to CF in vivo and in vitro (NACFC 2026) - "Sputum neutrophils from NCFBE patients on brensocatib were still indicative of this pathological programming, albeit to a reduced extent (Fig... Combined analysis of NCFBE sputum and blood using direct immunophenotyping and our biomimetic small airway model identify a pathophysiological path to neutrophil reprogramming, similar to what we previously described in CF. Our findings highlight a conserved pathobiological path across different NCFBE etiologies and a new approach methodology to test candidate drugs targeting NCFBE neutrophil airway dysfunction."

Preclinical • Bronchiectasis • Genetic Disorders • Immunology • Infectious Disease • Inflammation • Non‐Cystic Fibrosis Bronchiectasis • Otorhinolaryngology • Pulmonary Disease • Respiratory Diseases • CEACAM8

Insmed to Present Data Across Its Respiratory Portfolio (Insmed Press Release) - “Data will be presented...from a post hoc analysis of the Phase 3 ASPEN study of BRINSUPRI (brensocatib), the first and only approved treatment for non-cystic fibrosis bronchiectasis (NCFB)...The presentation, ‘Brensocatib in Patients With Non-Cystic Fibrosis Bronchiectasis (NCFB) and History of Nontuberculous Mycobacteria (NTM) Infection: A Post Hoc Analysis of the ASPEN Trial,’ is scheduled for Sept. 6, 2026.”

P3 data • Immunology • Non‐Cystic Fibrosis Bronchiectasis • Respiratory Diseases

BRINSUPRI (brensocatib) Approved by Japan's Ministry of Health, Labour and Welfare for the Treatment of Patients With Non-Cystic Fibrosis Bronchiectasis, a Serious, Chronic Lung Disease (PRNewswire) - "The approval of BRINSUPRI by the MHLW for the treatment of patients living with NCFB is based on results from the Phase 3 ASPEN study, which demonstrated that brensocatib significantly reduced pulmonary exacerbations compared with placebo over the 52-week treatment period and met multiple key secondary endpoints, including significantly prolonging the time to first exacerbation and significantly increasing the proportion of patients remaining exacerbation-free over the treatment period."

Japan approval • Non‐Cystic Fibrosis Bronchiectasis

Progress and Anticipated Milestones by Therapeutic Area (PRNewswire) - "BRINSUPRI global revenue grew 49% in the second quarter of 2026 compared to the first quarter of 2026, driven by strong growth in the U.S. market; Insmed continues to anticipate a regulatory decision for brensocatib for the treatment of non-cystic fibrosis bronchiectasis (NCFB) in Japan in the second half of 2026."

Japan approval • Sales • Immunology • Non‐Cystic Fibrosis Bronchiectasis

The Drug Update: Recent drug approvals, summer 2026 edition. (PubMed, Nurse Pract) - "This article highlights the following new medications: brensocatib (Brinsupri), elinzanetant (Lynkuet), and zoliflodacin (Nuzolvence). Additionally, this article reviews newly approved indications for existing therapies, including finerenone (Kerendia) for heart failure with a left ventricular ejection fraction of >_ 40% and cyclobenzaprine hydrochloride sublingual tablets (Tonmya) for fibromyalgia."

Journal • Bronchiectasis • Cardiovascular • Congestive Heart Failure • Fibromyalgia • Heart Failure • Musculoskeletal Pain • Pain • Pulmonary Disease • Respiratory Diseases • Rheumatology

Inhibition of Cathepsin C attenuates osteoarthritis by modulating macrophage activated status and reducing tissue inflammatory responses. (PubMed, Bone Joint Res) - "In addition, we used CatC knockdown mice and specific CatC inhibitors AZD7986 to verify the impact of CatC inhibition on OA progress...This study demonstrates that macrophage-derived CatC contributes to OA progression through upregulation of inflammatory mediators and MMP13. These findings suggest that CatC may represent a potential therapeutic target warranting further investigation."

Journal • Immunology • Inflammation • Osteoarthritis • Pain • Rheumatology • CTSC • MMP13

Efficacy and Safety of Brensocatib in Participants of Asian Race with Non-cystic Fibrosis Bronchiectasis: A Subgroup Analysis of the ASPEN Trial. (PubMed, Pulm Ther) - P3 | "In participants of Asian race, brensocatib 10 mg and 25 mg reduced the burden of pulmonary exacerbations, and the 25-mg dose reduced lung function decline and improved patient-reported symptoms versus placebo. The efficacy and safety of brensocatib in participants of Asian race were largely consistent with the overall ASPEN population, with select outcomes showing numerically greater benefit, although ASPEN was not powered to detect treatment differences in prespecified subgroup analyses."

Journal • Bronchiectasis • Genetic Disorders • Immunology • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

LTF promotes central nervous system leukemia progression via neutrophil serine proteases. (PubMed, Front Pharmacol) - "Mechanistically, neutrophil serine proteases (NSPs) act as downstream effectors of LTF, and pharmacological inhibition with Brensocatib effectively blocks AML cell entry into the brain. Our findings establish LTF as a mediator of CNS infiltration in AML and highlight NSP inhibition as a promising therapeutic strategy."

Journal • Acute Myelogenous Leukemia • Central Nervous System Leukemia • Hematological Malignancies • Leukemia • Oncology

Brensocatib in non-cystic fibrosis bronchiectasis: targeting neutrophil-driven inflammation through DPP-1 inhibition. (PubMed, Ann Med Surg (Lond)) - No abstract available

Journal • Bronchiectasis • Genetic Disorders • Immunology • Inflammation • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

CEDAR: A Study of the Efficacy and Safety of Brensocatib in Adults With Moderate to Severe Hidradenitis Suppurativa (HS) (clinicaltrials.gov) - P2 | N=214 | Terminated | Sponsor: Insmed Incorporated | Trial completion date: Nov 2026 ➔ Jun 2026 | Active, not recruiting ➔ Terminated; Lack of Efficacy

Trial completion date • Trial termination • Dermatology • Hidradenitis Suppurativa • Immunology

EMBARC…announced today at the World Bronchiectasis Conference (WBC 2026), its intention to collaborate with Insmed Incorporated to evaluate brensocatib 25 mg (GlobeNewswire) - "The study will be designed to deepen understanding of the long-term use of brensocatib and whether it has the potential to modify the course of the disease."

Licensing / partnership • New trial • Bronchiectasis