Brinsupri (Brensocatib) Webinar Summary

Posted by Sue, Volunteer Mentor @sueinmn, Aug 29 9:13pm

Below you can find my take on the runningonair/NTMir Webinar on Brinsupri.

This talk did not cover side effects and similar information. I will keep an eye out for that info and post it here as found.

What is my takeaway? This is an exciting development, but not a cure, nor even a full treatment for Bronchiectasis.

According to Dr O'Donnell, you still need to do everything you do today - just add this drug and hopefully reduce your exacerbations. The one year results show a 20-25% reduction in exacerbations. If you have 2 per now, you may be down to 3 every 2 years. We don't know yet if results improve over time.

The cost is high, and it is not yet clear how Medicare, Medicaid and private insurance companies will handle cost sharing.

What will I do? Watch and wait - I think in my risk/benefit world, it is too far from a sure thing yet.

Shared files

Brinsupri Webinar 08282025 (Brinsupri-Webinar-08282025.pdf)

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

scoop | @scoop | Aug 30 12:52pm

Thanks, Sue, for writing this up. I listened with one ear also. I know a missed a lot and look forward to the rerun. This is what I remember from the webinar but I've read so much about this drug that's it is possible I am conflating several sources of info, so tread carefully!

The molecule was discovered in 2016 by one bio company and then sold to Insmed, who then developed it into brensocatib.

Dr. O'Donnell cited adverse events (side effects) from the NEJM article. Hyperplasia skin thickening (she showed a photo, looked like calluses on hands) she cited 1.4% on 10mg, 3% on 25mg, and 0.7% on placebo. Interestingly, periodontal issues/gingivitis was 1.4% on 10mg, 2.1% on 25mg and 2.7% on placebo. So, those on the placebo experienced more periodontal issues/gingivitis than those on Brensocatib! From my understanding, these side effects are reversible once the drug is stopped.

It takes a while to work (24 weeks) because the neutrophils are produced in the bone marrow and the body has quite a store of them. Apparently, it's a slow process to produce new ones and replace the old neutrophils in the body. It's the neutrophil elastase, an enzyme, which causes mucus to become sticky and hard to clear. More neutrophils recruited to the lungs due to infection and inflammation, therefore more neutrophil elastase and more gunk! Brensocatib reduces neutrophils elastase activity and theoretically, the gunk.

I had hoped to hear more details about specifics on brenso might improve daily life but I guess that was not measured by its parts. The QoL (quality of life) percentages were modest on the 25mg dose. Also of note, the clinical trials were run during covid times. We were all so careful then and were not exposed to cold viruses, flu etc as much as during non-covid times.

My pulmonologist recommends I start with the 25mg dose and I am moving forward through the process. I'm anxious to slow down the vicious cycle of bronchiectasis. If there are untenable side effects I will stop the drug.