Recent results from the ASPEN trial indicate that both the 10 mg and 25 mg doses of brensocatib are associated with a lower rate of pulmonary exacerbations and better lung function in adolescent patients, as compared with placebo. The results were presented at the American Thoracic Society International Conference.
“Neutrophilic inflammation plays a key role in the pathophysiology of bronchiectasis. Neutrophil serine proteases (NSPs), especially neutrophil elastase, have been associated with disease progression and poorer clinical outcomes,” wrote the authors, led by Bernard Maitre of the Pulmonology Department at Centre Hospitalier Intercommunal de Créteil in France.
The phase 3, randomized, double-blind ASPEN trial is examining the use of brensocatib, an oral, selective, competitive, and reversible inhibitor of dipeptidyl peptidase 1, which prevents activation of NSPs. The study, which includes patients aged 12 to 85, has found that once-daily administration of a 10 or 25 mg dose significantly reduces the annualized rate of pulmonary exacerbations over 52 weeks compared to placebo.
The current APSEN analysis focused on outcomes among 41 participants aged 12 to 18 years. Of those, 17 patients received 10 mg, 16 received 25 mg, and eight received placebo. The adolescents’ demographic and baseline characteristics were similar.
The analysis found a reduction of 59% and 27% in the annualized rate of adjudicated pulmonary exacerbations among those receiving 10 mg and 25 mg brensocatib, respectively. More patients who received the medication versus those who received the placebo remained free of exacerbations through 52 weeks. They also experienced improvements in FEV1 (forced expiratory volume in one second), whereas the placebo group showed a decline in lung function. Adverse events were similar among groups.
Reference
Maitre B, Chalmers JD, Burgel PR, et al. Exacerbation rate and lung function in adolescent patients with non-cystic fibrosis bronchiectasis: an analysis of the ASPEN trial. Abstract #A7421. Presented at the American Thoracic Society International Conference; May 18-21, 2025; San Francisco, California.
