Bronchiectasis is a long-term lung condition where the airways stay widened and inflamed. These airway changes make it harder to breathe and clear mucus.
People with bronchiectasis live with a constant wet cough, shortness of breath, fatigue, and frequent respiratory infections. People also experience flare-ups (exacerbations) when their symptoms get worse and may even require a hospital stay. The condition tends to get worse over time due to an ongoing cycle of mucus buildup, infections, and airway inflammation.
Bronchiectasis can be caused by cystic fibrosis (CF), a genetic disorder that leads to very thick mucus. When it happens in people without CF, it’s called non-cystic fibrosis bronchiectasis, or NCFB for short. It affects about half a million people in the U.S.
Until recently, medical care for NCFB mainly focused on easing symptoms. In August 2025, the FDA approved Brinsupri (brensocatib) as the first medicine to treat NCFB.
Brinsupri may also be used for other conditions as determined by your health care provider. This article covers some frequently asked questions about Brinsupri for bronchiectasis.
Is Brinsupri Right for Me?
To see if Brinsupri is right for you, your health care provider will consider things like how your lungs look on scans, the cause of your bronchiectasis, and your medical history.
Brinsupri is FDA-approved to treat non-cystic fibrosis bronchiectasis (NCFB) in adults and children ages 12 and older.
How Does Brinsupri Work for NCFB?
Neutrophils are a type of white blood cell and are part of the immune system. They help fight infection and protect the body, but they also trigger inflammation (swelling). Over time, inflammation can damage healthy tissue.
Certain proteins in neutrophils, called neutrophil serine proteases (NSPs), can become overactive and lead to airway inflammation in people with non-cystic fibrosis bronchiectasis (NCFB). High levels of NSPs in mucus are linked to a higher risk of flare-ups in people with bronchiectasis.
Brinsupri works by blocking an enzyme called dipeptidyl peptidase 1 (DPP1). This enzyme normally activates NSPs in neutrophils. By blocking DPP1, Brinsupri helps prevent these proteins from becoming active, which may reduce inflammation. This can reduce the risk of flare-ups in people with NCFB.
How Do I Take Brinsupri?
Brinsupri comes as a tablet that you swallow. The recommended dosage of Brinsupri is 10 milligrams or 25 milligrams once daily. You can take Brinsupri with or without food.
Your health care provider will recommend an appropriate dose for you. Always follow your provider’s instructions.
What Can I Do to Prevent or Manage Side Effects of Brinsupri?
Like most medicines, Brinsupri can cause side effects. Not everyone will have them, and some may be mild, but it is important to know what to watch for and how to manage them.
Skin problems. Brinsupri may cause skin-related side effects. The most common are rash, dry skin, and areas of rough, thickened skin (hyperkeratosis). Skin cancer is less common but possible.
For dry skin, try to use gentle moisturizers, drink plenty of fluids, and wear gloves when you wash dishes or handle household detergents. Check your skin regularly. Tell your health care provider if you notice any new rashes or skin changes. Your provider may send you to a dermatologist for an exam.
Gum and teeth problems. Brinsupri may cause gum or dental problems, such as sore or irritated gums and periodontal disease.
Get regular dental cleanings and checkups while taking Brinsupri. Brush and floss as recommended by your dentist, and report any new gum bleeding, soreness, or tooth changes right away.
Other possible Brinsupri side effects are upper respiratory infections, high blood pressure, and hair loss. Tell your health care provider if you have symptoms of an infection, such as fever or worsening cough. Your health care provider may check your blood pressure and prescribe treatment if necessary.
This is not a complete list of side effects. Talk with your health care provider if you have side effects that bother you. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
How Was Brinsupri Studied for NCFB?
Two clinical studies called ASPEN and WILLOW were done to test how well Brinsupri works for treating non-cystic fibrosis bronchiectasis (NCFB). In both studies, participants were randomly assigned to take Brinsupri 10 milligrams, Brinsupri 25 milligrams, or a placebo (a “fake” pill that does not contain any medicine) once daily. Neither the participants nor the researchers knew which one the participants were taking.
Adults could join the studies if they had a confirmed diagnosis of NCFB based on chest CT scans and at least two flare-ups (pulmonary exacerbations) in the past year. In ASPEN, adolescents could join if they had at least one flare-up in the past year.
People could not join the studies if they had bronchiectasis caused by cystic fibrosis or if their symptoms were mainly caused by chronic obstructive pulmonary disease (COPD) or asthma. Other exclusions included known or suspected immune system problems.
ASPEN was a 52-week study that included 1,721 people with NCFB. Most participants were adults (1,680) and 41 were adolescents ages 12 to 17. The average age was 60. About two-thirds (64%) were female and the rest were male. Most participants were White (74%), 11% were Asian, 9% did not report their race or race was unknown, 4% identified as more than one race, 1% were Black or African American, 1% were American Indian or Alaskan Native, and smaller numbers identified as other races. Some participants (30%) identified as Hispanic or Latino ethnicity.
Here are some other details about the participants at the start of the ASPEN study:
- Nearly one-third (29%) of participants had three or more flare-ups in the past year.
- About one-third (30%) were former smokers.
- More than a third (35%) tested positive for the bacteria Pseudomonas aeruginosa in their mucus (sputum).
- Many (19%) were taking ongoing (chronic) antibiotics.
The main goal of ASPEN was to measure how many flare-ups people had during the study period of one year.
WILLOW was a 24-week trial that included 256 people with NCFB. The participants were similar to those in the ASPEN study, except WILLOW only included adults (average age was 64). The main goal of WILLOW was to measure the time until the first flare-up during the study period of six months.
To count as a flare-up, a person had to experience worsening of at least three major symptoms over 48 hours and these changes led their health care provider to prescribe antibiotics. Major symptoms could include:
- Increased cough
- Increased amount of mucus (sputum) or change in mucus thickness or texture
- Mucus that looks more yellow, green, or brown than usual (increased purulence)
- Increased shortness of breath
- Decreased ability to walk or exercise
- Tiredness and/or generally not feeling well
- Coughing up blood or bloody mucus
What Are the Main Benefits of Brinsupri Based on Studies?
Both studies found that Brinsupri was more effective than a placebo for reducing the risk of flare-ups (pulmonary exacerbations) in people with non-cystic fibrosis bronchiectasis (NCFB).
The ASPEN study showed that Brinsupri significantly reduced flare-ups compared with placebo over one year.
- People taking a placebo had an average of 1.29 flare-ups.
- People taking Brinsupri 10 milligrams had an average of 1.02 flare-ups, which is about a 21% lower rate of flare-ups than those taking the placebo.
- People taking Brinsupri 25 milligrams had an average of 1.04 flare-ups, a 19% lower flare-up rate than those taking the placebo.
After six months, the WILLOW study showed that people taking Brinsupri went longer before having a flare-up than those taking a placebo.
Overall, these studies show that Brinsupri is an effective treatment for non-cystic fibrosis bronchiectasis (NCFB). Your results may vary.
Are There Additional Potential Benefits of Brinsupri Based on Studies?
The ASPEN study also measured secondary outcomes. While not the main goal of the study, secondary outcomes can help health care professionals and patients learn about other possible benefits of treatment.
The secondary outcomes included the time to first flare-up, how many people stayed exacerbation-free, the number of severe flare-ups (those requiring intravenous antibiotics and/or a hospital stay), and changes in lung function. Lung function was measured using FEV1, which is how much air a person could blow out of their lungs in one second.
The results after one year are shown in the table below.
Placebo | Brinsupri 10 mg | Brinsupri 25 mg | |
Time to first flare-up (median*) | 37 weeks | 49 weeks | 51 weeks |
Percentage of people who had zero flare-ups | 40% | 49% | 49% |
Number of severe flare-ups | 0.19 | 0.14 | 0.14 |
*Median refers to the middle value in a set of results.
As noted above, your results may vary. Talk with your health care provider if you have questions about what to expect from Brinsupri treatment.
What Are Other Unique Considerations to Be Aware Of?
Tell your health care provider before getting any vaccines while taking Brinsupri. The use of live vaccines has not been studied in people taking Brinsupri. Because Brinsupri affects certain white blood cells (neutrophils) that play a role in fighting infection, it is unknown whether Brinsupri may change how well these vaccines work or how safe they are. For this reason, live vaccines are usually avoided during Brinsupri treatment.
Is There Any Cost Assistance Available?
A cost assistance program is available from Insmed, the drugmaker of Brinsupri. It may reduce the amount you pay. Whether you qualify to enroll may depend on what type of insurance you have or if you are uninsured. Visit this website from the drugmaker for more information about Brinsupri savings and support.
You can also contact the drugmaker at 833-544-4800 to connect with a representative for financial support information and other resources.
