Brinsupri follow-up

Posted by scoop @scoop, Sep 29, 2025

It seems a bunch of us have started Brinsupri. Let's use this thread for discussion. If you are taking Brinsupri have you noticed anything different, including changes to bronchiectasis or side effects? How long have you been on it?

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

I’m about to finish my 4th month on Brinsupri . I’ve definitely had less mucus and coughing . I did catch a bug in December , but azithromycin seemed to knock it out quicker than normal . No steroids were needed . The mucus kicked back up during that time , and was the slowest exacerbation symptom to get back to pre illness levels. I have mild BE, and I’m on 10mg. So far the only significant side effect was that it was causing insomnia . The pharmacist recommended to take in the morning , as I had been taking it at bedtime . The insomnia was relieved with the a.m. dosage change.

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@lss111
1. Has Brinsupri significantly improved your lung function, decreased flares and when you began to improve? No PFTs yet since starting Brinsupri 4 months ago. Feel better overall, more energy. Most days less sputum.

2. I read it may take 4-6 months for approval- experience with approval process, has anyone been denied? Mine took around 1 month.

3. I am concerned about serious side effects. (everyone is!)
Skin - Literature/trial data show there's an increase in SCC, BCC (non-melanoma skin cancers) in those taking 25mg Brinsupri [less than 1 person per 100]. I've had to move up my derm check as there are a couple of spots I want checked. Being cautious and conservative. I see derm 2x year as I've had lots of UV exposure and have fair skin. If SCC or BCC diagnosed will move up to 4x year checks. Hard to know if they are related to Brinsupri. These skin cancers are very very common in older adults.
Hair loss- none that I am unaware. Hair naturally thins with age anyway.
Dental- Take good care of teeth with twice a day brushing, flossing and fluoride rinse. Early gum disease is reversible.

My advice: try it you can always stop it. It's the ONLY FDA approved treatment for bronchiectasis, documented to slow progression.

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Profile picture for irenea8 @irenea8

@lss111
Hello! If you have not already done so, I would recommend reading through all the previous posts on this thread (Brinsupri follow up). It will be interesting to see how your approval process goes since we seem to have the same everything. My pulmologist and I also started the process of getting approval yesterday and I also have Medicare A, B and Supplement Plan G and MedicareRx through United Health Care. I have the Rx that has the lower premium of their two options. Given your pre existing and the potential side effects of Brinsupri, I would be very wary too! I am also concerned about certain side effects in my case. Let's hope for the best. I am concerned also that United will cover it but that my share will still be too high.

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@irenea8 Hope the approval and all goes well Irenea. I will be looking forward to hearing all, the experience with securing the Brinsupri and how you do with it, if you feel up to it down the line.
Barbara

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I started on Brinsupri on 9/11 and initially it made me cough a lot more. That was the only thing I noticed. Now after 4 months the coughing is less much less then even before taking the med. I curious if they start everyone on 25 mg or 10 mg?

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Profile picture for scoop @scoop

@lss111
1. Has Brinsupri significantly improved your lung function, decreased flares and when you began to improve? No PFTs yet since starting Brinsupri 4 months ago. Feel better overall, more energy. Most days less sputum.

2. I read it may take 4-6 months for approval- experience with approval process, has anyone been denied? Mine took around 1 month.

3. I am concerned about serious side effects. (everyone is!)
Skin - Literature/trial data show there's an increase in SCC, BCC (non-melanoma skin cancers) in those taking 25mg Brinsupri [less than 1 person per 100]. I've had to move up my derm check as there are a couple of spots I want checked. Being cautious and conservative. I see derm 2x year as I've had lots of UV exposure and have fair skin. If SCC or BCC diagnosed will move up to 4x year checks. Hard to know if they are related to Brinsupri. These skin cancers are very very common in older adults.
Hair loss- none that I am unaware. Hair naturally thins with age anyway.
Dental- Take good care of teeth with twice a day brushing, flossing and fluoride rinse. Early gum disease is reversible.

My advice: try it you can always stop it. It's the ONLY FDA approved treatment for bronchiectasis, documented to slow progression.

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@scoop I’m curious how you know that 1 in 100 people take the 25 mg regimen. Did I read that correctly? I am on the 25mg.

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Profile picture for patti55 @patti55

@scoop I’m curious how you know that 1 in 100 people take the 25 mg regimen. Did I read that correctly? I am on the 25mg.

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@patti55 Sorry I was not clear. From Brinsupri insert:
Skin Cancers: In ASPEN, the incidence of skin cancers among patients treated with BRINSUPRI 10 mg and 25 mg was 0.5% and 1.9%, respectively, compared to 1.1% in placebo-treated patients.

So on placebo 1.1% of patients developed BCC or SCC (non-melanoma skin cancers). Of those on 25mg Brinsupri, 1.9% developed skin cancer. The difference between 1.9% and 1.1% is 0.8%, which is less than 1% or 1 in 100.

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Profile picture for scoop @scoop

@patti55 Sorry I was not clear. From Brinsupri insert:
Skin Cancers: In ASPEN, the incidence of skin cancers among patients treated with BRINSUPRI 10 mg and 25 mg was 0.5% and 1.9%, respectively, compared to 1.1% in placebo-treated patients.

So on placebo 1.1% of patients developed BCC or SCC (non-melanoma skin cancers). Of those on 25mg Brinsupri, 1.9% developed skin cancer. The difference between 1.9% and 1.1% is 0.8%, which is less than 1% or 1 in 100.

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@scoop Thanks for the clarification on that. I appreciate it.

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I am on month 4 of brinsupri. Today I noticed an itchy small patch on my thigh- looks reddish and bumpy as if empty under the itchy part of the skin, kind of dry on the surface. I will observe how it develops. So far I put some hydrocortisone on it. I really hope it’s not the starting the dermatological side effect of brinsupri. I know from here some had it. How was it dealt with. Thank you

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Profile picture for lss111 @lss111

Hello,
I was diagnosed with bronchchietasis in 2023. Doing fairly well with inhaler and nebulizer. Since 3/2025 I have had a increase in number of flairs after head colds. Also a increase in coughing daily, fatigue, shortness of breath, dramatic decrease in ability to do minimal home chores. I also have lymphocytic colitis dx. 2023 again flairs making it impossible to leave my home.
I know BE flairs increases lung damage and lung function hence interest in Brinsupri.
My pulmologist and I started the process of getting approval yesterday. I have Medicare A, B and
Supplement Plan G., MedicareRx through United Health Care. Since I read so many of contributors of the forum are on Brinsupri I am reaching out to you:
1. Has Brinsupri significantly improved you lung function, decreased flairs and when you began to improve?
2. I read it may take 4-6 month for approval- experience with approval process, has anyone been denied?
3. I am concerned about serious side effects.
Skin - I have had 2 squamous cell carcinomas (family history of melanoma,) eczema, actinic keratosis (precurser to possible skin cancer). I have full body exams by a dermatologist every 3 months.
Hair loss- I have Androgenic alopecia or Female Pattern Baldness and Telogen Effluvium (TE) and I am being treated with some improvement.
Dental- Tooth loss, multiple crowns, implants ( due to over drilling as a child, teen, adult) In general significant dental problems. I see the dentist every 3 months.

I am interested in your experience on this drug.
For example, problems with coverage, has Brinsupri improved your lung function or not, incidence of side effects and if so management.

Any thing you feel comfortable in sharing with me. I am concerned.
I appreciate you help and look forward to hearing back.

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@lss111
Thanks to all.

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