Unmet Needs for Non-Cystic Fibrosis Bronchiectasis, with James D. Chalmers, MBChB, PhD

Brensocatib, currently under US Food and Drug Administration (FDA) Priority Review, could become the first approved treatment for non-cystic fibrosis bronchiectasis and the first dipeptidyl peptidase 1 (DPP1) inhibitor, offering a novel approach to management of neutrophil-driven inflammation.1

New findings on brensocatib from the ASPEN study were highlighted by James D. Chalmers, MBChB, PhD, professor of respiratory research at the University of Dundee, in a recent interview at the American Thoracic Society (ATS) International Conference in San Francisco, with consistent efficacy and safety being identified across all key patient subgroups. In this video segment, Chalmers highlighted several more unique takeaways from the subgroup analysis findings.

“We have so many unmet needs in bronchiectasis, it's hard to know where to start,” Chalmers said. “This has been an incredibly neglected disease. It's been very little research over the last 20 to 30 years. It's great that we're starting to see an uptick in interest in this disease, recognizing it's a disease with a very high burden. It's really common, which means we really need to invest more into tackling some of these unmet needs. If you talk to a patient, what are the biggest concerns: frequent exacerbations, daily symptoms, and the concern that they're going to get worse over time. So it's really encouraging that brensocatib, if approved, looks like it would be able to address a lot of that.”

Chalmers highlighted additional unmet needs among patients with non-cystic fibrosis bronchiectasis. He noted the need for more treatments for people with bronchiectasis and the necessity of a concerted effort to diagnose the condition earlier and intervene in this condition earlier.

“Because unfortunately, that remains a big problem and many patients are undiagnosed,” Chalmers explained. “Many patients are misdiagnosed as having other conditions.”

Chalmers was also asked about what he hopes will be the biggest takeaways from the ASPEN trial findings on brensocatib, the subgroup analysis findings, and non-cystic fibrosis bronchiectasis in general.

“I'll start with brensocatib,” Chalmers said. “This is the first therapy that's been shown to be effective, and if approved, I hope that these data will reassure people that the efficacy is there. So there's a significant effect on exacerbations and on progression of disease, and it's consistent across all patient subpopulations, suggesting this can be a broadly applicable therapy. The second message, I would say, is inflammation. This is an anti-inflammatory therapy, and this validates the concept that targeting inflammation is a key way to treat people with bronchiectasis.”

In terms of what this would mean for clinicians and patients, Chalmers clarified that it would allow a reduced reliance on antibiotic implementation. He added that this is many patients’ biggest frustration, with constant consumption of antibiotics and their related side effects.

“The third thing I want to say as a key message is that we could have all the effective therapies in the world, but if we don't diagnose patients and get patients to the right care, they will never get access to those therapies and they won't have the effect they should,” Chalmers explained. “...Now that we have effective therapies, we should be prioritizing identifying these patients, diagnosing them earlier, and giving them access to the treatments that they need.”

To learn more about this data, view the full interview segment posted above. For more on late-breaking data and interviews at ATS, view our latest conference coverage.

The quotes implemented in this summary were edited for clarity.

References

1. Brensocatib Shows Consistent Efficacy and Safety Across Three Prespecified Subgroups in New Data from Landmark ASPEN Study. Insmed Incorporated. May 21, 2025. https://www.prnewswire.com/news-releases/brensocatib-shows-consistent-efficacy-and-safety-across-three-prespecified-subgroups-in-new-data-from-landmark-aspen-study-302462008.html?tc=eml_cleartime.