Frequent exacerbations are common in patients with bronchiectasis, which are thought to be related to neutrophilic inflammation. Bronchiectasis at baseline is characterized by the increased activity and quantity of neutrophil serine proteases. Brensocatib is a reversible dipeptidyl peptidase 1 (DPP-1) inhibitor and could inhibit the activation of neutrophil serine proteases. This study aims to evaluate the efficacy of brensocatib for the treatment of bronchiectasis.

This randomized, phase-2, placebo-controlled, double-blind trial included a total of 256 patients with bronchiectasis and at least two exacerbations in the previous year. The patients were randomly assigned in a 1:1:1 ratio to receive brensocatib (10 mg), brensocatib (25 mg), and placebo. The primary outcome of the study was the first time first exacerbation.

The 25th percentile of the time to first exacerbation was 134 days in the 10-mg brensocatib group, 96 days in the 25-mg brensocatib group, and 67 days in the placebo group. The findings suggested that brensocatib treatment prolonged the time to first exacerbation as compared with placebo. The incidence of adverse events, mainly skin and dental events, was higher in the 10-mg and 25-mg brensocatib groups.

The research concluded that brensocatib treatment from bronchiectasis was associated with a reduced frequency of exacerbations when compared with placebo.