@ubaldo45
The clinical trial evidence shows it helps bronchiectasis. The clinical trials did NOT exclude those with MAC/NTM disease but that subgroup was not individually studied. Reassuringly, pneumonia was more common in the placebo group. Brinsupri theoretically helps interrupt the vicious vortex but there needs to be more studies about it as it relates to those with MAC/NTM. So my final thought is that it depends on your risk tolerance around trying new drugs. I suggest reading through the brinsupri literature carefully and discussing with your pulmonologist. Good luck with your decision.
https://insmed.com/pdf/brinsupri_full_prescribing_information.pdf
Adding that twice a day airway clearance continues to be essential despite being on brinsupri. You mention being exhausted all the time. Is that from airway clearance? Or from the disease itself?