RX Review: A New Era of Disease-Modifying Therapy for Bronchiectasis - Episode 5
In this video, the last in a 5-part series, panelists discuss their future outlook on bronchiectasis management.
In the concluding portion of the HCPLive RX Review Special Report, Albert Rizzo, MD, and James Chalmers, MBChB, PhD, discuss how the August 2025 FDA approval of brensocatib (marketed as Brinsupri), the first disease modifying therapy for bronchiectasis, may shift therapeutic goals in the field beyond exacerbation reduction and toward long-term preservation of pulmonary health.
Rizzo and Chalmers then discuss how trial endpoints in the field may evolve to focus on disease modification and slowing decline, and may include measures such as CT imaging and radiographic markers of airway damage, complementing traditional exacerbation rates and lung function outcomes.
Both experts reflect on the broader impact of this therapeutic advance. Chalmers anticipates increased recognition and diagnosis of bronchiectasis now that a targeted therapy is available, similar to the paradigm shift seen in interstitial lung disease after antifibrotic approvals. He stresses the need for collaboration across primary care, community pulmonology, and specialty centers to manage a condition that affects an estimated one million patients in the U.S. Importantly, he underscores that brensocatib should be viewed as one element of comprehensive care—alongside airway clearance, infection management, and evaluation of underlying causes—rather than a standalone solution.
"I think we're going to see a lot more attention to bronchiectasis. It's really been very much a Cinderella condition... and the availability of a new therapy, it gets people interested, it gives people a reason to diagnose it, because there's something powerful and effective that they can do about it," Chalmers said.
Part 1: Shifting Bronchiectasis Treatment Toward Disease Modification
Part 2: Brensocatib Brings DPP1 Inhibition to the Bronchiectasis Field
Part 3: Understanding Brensocatib's Mechanism and Safety in Bronchiectasis
Part 4: Brensocatib's Place in Clinical Care of Bronchiectasis
Part 5: Redefining Bronchiectasis Research and Management With First FDA Approval
Our Panelists:
Albert Rizzo, MD, is a pulmonologist at ChristianaCare Pulmonary Associates at the ChristianaCare in Newark, Delaware, and clinical assistant professor of medicine at Thomas Jefferson University Medical School, Philadelphia. Triple board certified in internal medicine, pulmonary, critical care and sleep medicine, he also served as the former Chief Medical Officer of the American Lung Association.
James Chalmers, MBChB, PhD, is a Clinical Professor (Teaching and Research) of Respiratory Research, Respiratory Medicine and Gastroenterology, at University of Dundee, United Kingdom, where he also serves as Asthma and Lung UK Chair of Respiratory Research. He was a primary investigator on Insmed's ASPEN trial of brensocatib.
Editor's note: Rizzo's disclosures include Pfizer, AstraZeneca, and Genentech. Chalmer's disclosures include AstraZeneca, Boehringer Ingelheim, Genentech, Gilead, Grifols Biologicals, Insmed, Novartis, and Zambon.
