According to an analysis from the ASPEN trial, both the 10 mg and 25 mg doses of brensocatib reduced the rate of bronchiectasis exacerbations, and the 25 mg dose also improved patient-reported symptoms and prevented declines in lung function, regardless of high or low eosinophil counts at baseline. The findings were presented at the American Thoracic Society International Conference.
Brensocatib is an oral, selective, competitive, and reversible inhibitor of dipeptidyl peptidase 1 that affects neutrophilic inflammation, a key factor in the pathophysiology of bronchiectasis. The drug prevents activation of neutrophil serine proteases, which have been associated with bronchiectasis progression and poorer clinical outcomes.
ASPEN is a phase 3, randomized, double-blind trial studying the effectiveness of once-daily brensocatib in 10 and 25 mg doses. Previous results have shown that the treatment significantly reduced the annualized rate of adjudicated pulmonary exacerbations over 52 weeks versus placebo. ASPEN also found that the 25 mg dose lessened declines in lung function and improved patient-reported symptoms. The current analysis sought to explore whether these results remained true among patients with eosinophilia.
“Eosinophilia is also present in about 20% of patients with bronchiectasis—a subtype of the condition, which has been called ‘eosinophilic bronchiectasis,’” wrote the authors, led by James Chalmers of the Department of Respiratory Medicine and Gastroenterology at the University of Dundee in the United Kingdom.
They examined results among patients with and without eosinophilic bronchiectasis. Thesubgroup analysis included patients with high (≥ 300/mm3) or low (< 300/mm3) blood eosinophil counts at initial screening.
Consistent with overall results from ASPEN, brensocatib reduced the annualized rate of exacerbations, prolonged the time to first exacerbation, and increased the odds of remaining exacerbation-free in both groups. Also similar to the overall ASPEN results, the 25 mg dose reduced declines in both FEV1 (forced expiratory volume in 1 second) and forced vital capacity in both groups. The drug also improved scores on the Quality of Life-Bronchiectasis Respiratory Symptoms Domain. These results did not differ between the low and high eosinophil groups.
Reference American Thoracic Society International Conference. Abstract #A5239. https://www.atsjournals.org/doi/abs/10.1164/ajrccm.2025.211.Abstracts.A5239
