RX Review: A New Era of Disease-Modifying Therapy for Bronchiectasis - Episode 1
In this video, the first in a 5-part series, panelists discuss recent advancements in bronchiectasis management.
In this HCPLive RX Review Special Report, Albert Rizzo, MD, pulmonologist at ChristianaCare Pulmonary Associates at the ChristianaCare in Newark, Delaware, joins James Chalmers, MBChB, PhD, Professor of Respiratory Medicine at the University of Dundee, to discuss evolving challenges and new opportunities in bronchiectasis management. In this clip, the duo emphasizes the disease’s growing prevalence, chronic morbidity, and the longstanding absence of disease-modifying therapies until the recent United States Food and Dug Administration approval of brensocatib in August 2025 under the name Brinsupri.
Chalmers highlights several critical unmet needs, beginning with delayed diagnosis—often a decade or more after symptom onset—driven by barriers such as limited access to high-resolution CT imaging and underrecognition of underlying etiologies. He notes that bronchiectasis is a heterogeneous condition with more than 100 potential causes, yet testing for immune deficiency, genetic disorders, or nontuberculous mycobacteria is inconsistently applied in clinical practice. This contributes to challenges in risk assessment and personalized care, leaving many patients underdiagnosed or undertreated.
Turning to treatment strategies, the experts stress that while airway clearance remains an essential component of symptom management, it does not alter disease progression. They also point to the risks of antibiotic overuse and resistance, underscoring the importance of emerging anti-inflammatory therapies aimed at reducing exacerbation frequency. With brensocatib marking the first approved disease-modifying therapy, Rizzo and Chalmers underscore the need for earlier diagnosis, broader testing, and a pipeline of new therapeutic approaches to shift bronchiectasis care from supportive management to true disease modification.
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.
