What Is Brensocatib?
Brensocatib is a new type of anti-inflammatory medicine being developed to protect the lungs from long-term damage caused by overactive immune cells, especially neutrophils.
It is being tested by the company Insmed in people with bronchiectasis, but it may also help those with aspergillosis and other chronic lung diseases where inflammation is a major problem.
Brensocatib is taken as a once-daily tablet—not an injection.
Why Was It Developed?
In conditions like ABPA (Allergic Bronchopulmonary Aspergillosis) and CPA (Chronic Pulmonary Aspergillosis), inflammation is often persistent.
The lungs attract neutrophils, which are immune cells that normally destroy germs.
However, when too many neutrophils gather, they release enzymes that damage healthy lung tissue, thicken mucus, and make infection easier for fungi and bacteria.
Researchers realised that if they could turn down the destructive part of neutrophil activity—without turning off the immune system completely—they might be able to break the cycle of inflammation and infection.
How Brensocatib Works
Brensocatib blocks a switch inside the bone marrow called DPP1 (dipeptidyl peptidase-1).
DPP1’s job is to “activate” enzymes inside newly formed neutrophils before they enter the bloodstream.
By blocking DPP1, brensocatib stops neutrophils from producing harmful enzymes such as neutrophil elastase.
These neutrophils can still travel to the lungs and fight infection, but they cause less collateral damage.
👉 In short: brensocatib reduces lung injury caused by over-active immune cells, not by suppressing immunity itself.
Not a Biologic – A Different Type of Treatment
It’s important to understand that brensocatib is not a biologic.
| Feature | Biologic drugs (e.g. mepolizumab, dupilumab) | Brensocatib |
|---|---|---|
| Made from | Complex proteins or antibodies | Small chemical molecule |
| How it’s given | Injection or infusion | Oral tablet |
| What it targets | Specific immune pathways (e.g. IL-5, IL-4) | Enzyme activation in neutrophils |
| Purpose | Block inflammatory signals | Reduce tissue-damaging enzymes |
| Typical use | Severe asthma, ABPA, autoimmune diseases | Bronchiectasis, chronic airway inflammation |
So, while biologics act by targeting immune messengers in the bloodstream, brensocatib works deeper—at the level of neutrophil development.
The two approaches are different but potentially complementary.
Some people in future may benefit from a combination, depending on their pattern of inflammation.
The Development Story
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Early research (2010s): Scientists found that blocking DPP1 prevented lung injury in animal studies.
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Insmed’s discovery: Brensocatib was developed as an oral, selective DPP1 inhibitor.
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Phase 2 WILLOW trial (2020): In people with bronchiectasis, brensocatib significantly reduced flare-ups and lowered airway inflammation.
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Phase 3 ASPEN trial (2022–2025): A large international study now nearing completion; results are expected soon.
If successful, brensocatib could become the first approved DPP1 inhibitor for long-term inflammatory lung disease.
Why This Matters for Aspergillosis Patients
People living with aspergillosis often also have bronchiectasis, where inflammation causes persistent mucus, infection, and breathlessness.
Current treatments such as steroids, antifungals, and biologics can help, but each has limits.
Brensocatib could:
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Reduce airway inflammation without steroid side-effects
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Protect lung tissue from further damage
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Possibly lower the number of flare-ups or infections
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Work safely alongside antifungals or biologics
It represents a new way of calming inflammation—by modifying neutrophil behaviour rather than blocking the immune system.
What Happens Next
The ASPEN Phase 3 results are expected soon. If positive, Insmed plans to apply for approval in the UK, EU, and USA.
Researchers are also studying brensocatib in:
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COPD (Chronic Obstructive Pulmonary Disease)
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Cystic fibrosis
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Nontuberculous mycobacterial (NTM) infections
If licensed, it could mark the first new oral anti-inflammatory class for chronic lung disease in decades.
Key Take-Home Messages
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Brensocatib reduces harmful lung inflammation by blocking the enzyme DPP1.
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It is a small-molecule tablet, not a biologic injection.
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It aims to protect the lungs by preventing damage from overactive neutrophils.
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It may offer a steroid-sparing option for chronic airway diseases like bronchiectasis and aspergillosis.
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It’s currently in final clinical trials, with results expected soon.
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