A summary of research published in the New England Journal of Medicine

A new drug has been found to reduce the number of exacerbations experienced by people living with bronchiectasis. The results of the Phase II clinical trial show that the drug Brensocatib could be a safe and effective treatment and offer a better quality of life for people living with the condition.

How does the drug work?

People with bronchiectasis regularly experience a flare up, or exacerbation, of their symptoms, which can cause infections and hospitalisation. Antibiotics are currently the only therapy available to help control infection. The new drug aims to target the source of the exacerbation and prevent it from happening before a person needs treatment.

Brensocatib works by stoppingdipeptidyl peptidase 1 (DPP1). This is an enzyme that is involved in white blood cells activity that is responsible for leading the body’s immune response to fight an infection. They play a central role in helping to manage inflammation which is a type of swelling in response to damage or infection in the body. In people with long-term lung conditions they can build-up in the airways and result in lung damage and inflammation. By stopping this enzyme, the drug could reduce the damaging effects of inflammation and prevent exacerbations.

What did the trial investigate?

This was a Phase II clinical trial. Phase II trials investigate the safety and the ideal amount of the drug that is needed and how often it should be taken. The trial included 256 people who had experienced at least two exacerbations in the last year. They were split into three groups – one received a placebo (a drug with no medicine is it that will not have an effect), one group receiving a smaller dose (10mg per day) of the drug and one receiving a larger dose of the drug (25m per day). The trial lasted for 24 weeks.

What did the results find?

The groups that took Brensocatib at both the larger and smaller doses took much longer until they experienced an exacerbation than the placebo group.

People taking the drug reduced their risk of exacerbations by almost one third compared to people taking the placebo.

The group that took the smaller dose of 10mg also had far fewer exacerbations throughout the year.

Why is this important?

Although there are two more stages of the trial to complete, experts are excited about these results. They provide evidence that this drug could be used to treat bronchiectasis directly, rather than just manage the symptoms. If exacerbations could be prevented in the first place, this could lead to a much better quality of life for people living with the condition.

Read the original research paper abstract and access full article (subscription):

Title: Phase 2 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis