Brensocatib Shows Consistent Efficacy and Safety Across Three Prespecified Subgroups in New Data from Landmark ASPEN Study
- Consistent efficacy demonstrated across all three key patient subgroups
- Significant reduction in exacerbation rates across all subgroups compared to placebo
- Improved lung function measurements in treated patients
- 59% of adolescent patients remained exacerbation-free vs 35% on placebo
- None.
Insights
Brensocatib shows consistent efficacy across key patient subgroups in Phase 3 NCFBE trial, strengthening its regulatory and commercial potential.
The new subgroup analyses from Insmed's Phase 3 ASPEN trial represent significant positive clinical evidence for brensocatib in non-cystic fibrosis bronchiectasis (NCFBE), a condition with no currently approved treatments. The data demonstrates consistent efficacy across three critical patient subgroups: adolescents, patients on macrolide therapy, and those with varying blood eosinophil levels.
Looking at the specific metrics, brensocatib at both 10mg and 25mg doses showed impressive results in reducing annualized exacerbation rates compared to placebo across all subgroups. Particularly notable is the adolescent data, where exacerbation rates were reduced to
The consistency in both efficacy and safety profiles across these diverse patient populations substantially strengthens brensocatib's clinical profile and regulatory case. For bronchiectasis—a heterogeneous disease affecting diverse patient types—demonstrating efficacy across subgroups is crucial for both regulatory approval and eventual physician adoption.
What's particularly valuable is the demonstrated effect on lung function preservation, with treated patients showing improvements in FEV₁ while placebo patients experienced decline. This suggests brensocatib may potentially modify disease progression, not just manage symptoms—a critical differentiator in respiratory therapeutics.
The breadth of data presented (11 abstracts across their respiratory portfolio) further reflects Insmed's comprehensive development approach and commitment to this therapeutic area, positioning them well for regulatory discussions and eventual commercialization strategies in this significant unmet medical need.
— Insmed Presented 11 Abstracts at ATS 2025 from Across Its Respiratory Portfolio, Including Data on ARIKAYCE®, TPIP and Health Economics and Outcomes Research —
"It is critical that we understand not only how brensocatib performed across the full
Three prespecified subgroup analyses from
- Adolescents: In adolescents, brensocatib 10 mg and 25 mg reduced annualized exacerbation rates vs placebo (annualized rates: 0.35 and 0.64 vs 0.87), with
59% of patients in both dose groups remaining exacerbation-free vs35% on placebo. Adolescent patients also experienced improvements in lung function as measured by forced expiratory volume in 1 second (FEV₁), while on either dose of brensocatib, while patients in the placebo group experienced FEV1 decline. - Maintenance macrolide use: Brensocatib demonstrated efficacy in patients regardless of maintenance use of macrolides (without vs with). Annualized exacerbation rates were lower with brensocatib (10 mg: 0.97/1.21; 25 mg: 0.98/1.21) vs placebo (1.23/1.54), and a greater proportion remained exacerbation-free across subgroups. Brensocatib 25 mg also reduced FEV₁ decline in both subgroups.
- Blood eosinophil level: Brensocatib 10 mg and 25 mg reduced annualized exacerbation rates, prolonged the time to first exacerbation, and increased the odds of remaining exacerbation-free in both subgroups of patients with high (≥300/mm3) or low (<300/mm3) blood eosinophil counts at baseline. Brensocatib 25-mg reduced lung function decline and numerically improved Quality of Life-Bronchiectasis Respiratory Symptoms Domain score (QOL-B RSS) at week 52 vs placebo regardless of baseline blood eosinophil count.
"These new analyses from ASPEN—the largest Phase 3 trial in bronchiectasis to date—demonstrated consistent efficacy and safety across three key patient groups, reinforcing the potential of brensocatib to deliver meaningful clinical benefit where no approved treatments currently exist," said Martina Flammer, M.D., Ph.D., Chief Medical Officer of Insmed. "The breadth and depth of our scientific contributions at ATS across our respiratory portfolio reflect our commitment and deep pride in advancing research that has the potential to transform care for patients with serious diseases."
Additional Insmed Data at ATS
Insmed also presented a post-hoc analysis from
About ASPEN
The total number of active sites in
About Bronchiectasis
Bronchiectasis is a serious, chronic lung disease in which the bronchi become permanently dilated due to a cycle of infection, inflammation, and lung tissue damage. The condition is marked by frequent pulmonary exacerbations requiring antibiotic therapy and/or hospitalizations. Symptoms include chronic cough, excessive sputum production, shortness of breath, and repeated respiratory infections, which can worsen the underlying condition. Today, approximately 500,000 patients in the
About Brensocatib
Brensocatib is a small molecule, oral, reversible inhibitor of dipeptidyl peptidase 1 (DPP1) being developed by Insmed for the treatment of patients with bronchiectasis, chronic rhinosinusitis without nasal polyps, hidradenitis suppurativa, and other neutrophil-mediated diseases. DPP1 is an enzyme responsible for activating neutrophil serine proteases (NSPs), such as neutrophil elastase, in neutrophils when they are formed in the bone marrow. Neutrophils are the most common type of white blood cell and play an essential role in pathogen destruction and inflammatory mediation. In chronic inflammatory lung diseases, neutrophils accumulate in the airways and result in excessive active NSPs that cause lung destruction and inflammation. Brensocatib may decrease the damaging effects of inflammatory diseases such as bronchiectasis by inhibiting DPP1 and its activation of NSPs. Brensocatib is an investigational drug product that has not been approved for any indication in any jurisdiction.
About TPIP
Treprostinil palmitil inhalation powder (TPIP) is a dry powder formulation of treprostinil palmitil, a treprostinil prodrug consisting of treprostinil linked by an ester bond to a 16-carbon chain. Developed entirely in Insmed's laboratories, TPIP is a potentially highly differentiated prostanoid being evaluated for the treatment of patients with pulmonary arterial hypertension (PAH), pulmonary hypertension associated with interstitial lung disease (PH-ILD), and other rare and serious pulmonary disorders. TPIP is administered in a capsule-based inhalation device. TPIP is an investigational drug product that has not been approved for any indication in any jurisdiction.
About ARIKAYCE
ARIKAYCE is approved in
About PARI Pharma and the Lamira® Nebulizer System
ARIKAYCE is delivered by a novel inhalation device, the Lamira® Nebulizer System, developed by PARI. Lamira® is a quiet, portable nebulizer that enables efficient aerosolization of ARIKAYCE via a vibrating, perforated membrane. Based on PARI's 100-year history working with aerosols, PARI is dedicated to advancing inhalation therapies by developing innovative delivery platforms to improve patient care.
IMPORTANT SAFETY INFORMATION AND BOXED WARNING FOR ARIKAYCE IN THE
WARNING: RISK OF INCREASED RESPIRATORY ADVERSE REACTIONS |
ARIKAYCE has been associated with an increased risk of respiratory adverse reactions, including hypersensitivity pneumonitis, hemoptysis, bronchospasm, and exacerbation of underlying pulmonary disease that have led to hospitalizations in some cases. |
Hypersensitivity Pneumonitis has been reported with the use of ARIKAYCE in the clinical trials. Hypersensitivity pneumonitis (reported as allergic alveolitis, pneumonitis, interstitial lung disease, allergic reaction to ARIKAYCE) was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (
Hemoptysis has been reported with the use of ARIKAYCE in the clinical trials. Hemoptysis was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (
Bronchospasm has been reported with the use of ARIKAYCE in the clinical trials. Bronchospasm (reported as asthma, bronchial hyperreactivity, bronchospasm, dyspnea, dyspnea exertional, prolonged expiration, throat tightness, wheezing) was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (
Exacerbations of underlying pulmonary disease has been reported with the use of ARIKAYCE in the clinical trials. Exacerbations of underlying pulmonary disease (reported as chronic obstructive pulmonary disease (COPD), infective exacerbation of COPD, infective exacerbation of bronchiectasis) have been reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (
Anaphylaxis and Hypersensitivity Reactions: Serious and potentially life-threatening hypersensitivity reactions, including anaphylaxis, have been reported in patients taking ARIKAYCE. Signs and symptoms include acute onset of skin and mucosal tissue hypersensitivity reactions (hives, itching, flushing, swollen lips/tongue/uvula), respiratory difficulty (shortness of breath, wheezing, stridor, cough), gastrointestinal symptoms (nausea, vomiting, diarrhea, crampy abdominal pain), and cardiovascular signs and symptoms of anaphylaxis (tachycardia, low blood pressure, syncope, incontinence, dizziness). Before therapy with ARIKAYCE is instituted, evaluate for previous hypersensitivity reactions to aminoglycosides. If anaphylaxis or a hypersensitivity reaction occurs, discontinue ARIKAYCE and institute appropriate supportive measures.
Ototoxicity has been reported with the use of ARIKAYCE in the clinical trials. Ototoxicity (including deafness, dizziness, presyncope, tinnitus, and vertigo) were reported with a higher frequency in patients treated with ARIKAYCE plus background regimen (
Nephrotoxicity was observed during the clinical trials of ARIKAYCE in patients with MAC lung disease but not at a higher frequency than background regimen alone. Nephrotoxicity has been associated with the aminoglycosides. Close monitoring of patients with known or suspected renal dysfunction may be needed when prescribing ARIKAYCE.
Neuromuscular Blockade: Patients with neuromuscular disorders were not enrolled in ARIKAYCE clinical trials. Patients with known or suspected neuromuscular disorders, such as myasthenia gravis, should be closely monitored since aminoglycosides may aggravate muscle weakness by blocking the release of acetylcholine at neuromuscular junctions.
Embryo-Fetal Toxicity: Aminoglycosides can cause fetal harm when administered to a pregnant woman. Aminoglycosides, including ARIKAYCE, may be associated with total, irreversible, bilateral congenital deafness in pediatric patients exposed in utero. Patients who use ARIKAYCE during pregnancy, or become pregnant while taking ARIKAYCE should be apprised of the potential hazard to the fetus.
Contraindications: ARIKAYCE is contraindicated in patients with known hypersensitivity to any aminoglycoside.
Most Common Adverse Reactions: The most common adverse reactions in Trial 1 at an incidence ≥
Drug Interactions: Avoid concomitant use of ARIKAYCE with medications associated with neurotoxicity, nephrotoxicity, and ototoxicity. Some diuretics can enhance aminoglycoside toxicity by altering aminoglycoside concentrations in serum and tissue. Avoid concomitant use of ARIKAYCE with ethacrynic acid, furosemide, urea, or intravenous mannitol.
Overdosage: Adverse reactions specifically associated with overdose of ARIKAYCE have not been identified. Acute toxicity should be treated with immediate withdrawal of ARIKAYCE, and baseline tests of renal function should be undertaken. Hemodialysis may be helpful in removing amikacin from the body. In all cases of suspected overdosage, physicians should contact the Regional Poison Control Center for information about effective treatment.
LIMITED POPULATION: ARIKAYCE® is indicated in adults, who have limited or no alternative treatment options, for the treatment of Mycobacterium avium complex (MAC) lung disease as part of a combination antibacterial drug regimen in patients who do not achieve negative sputum cultures after a minimum of 6 consecutive months of a multidrug background regimen therapy. As only limited clinical safety and effectiveness data for ARIKAYCE are currently available, reserve ARIKAYCE for use in adults who have limited or no alternative treatment options. This drug is indicated for use in a limited and specific population of patients.
This indication is approved under accelerated approval based on achieving sputum culture conversion (defined as 3 consecutive negative monthly sputum cultures) by Month 6. Clinical benefit has not yet been established. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.
Limitation of Use: ARIKAYCE has only been studied in patients with refractory MAC lung disease defined as patients who did not achieve negative sputum cultures after a minimum of 6 consecutive months of a multidrug background regimen therapy. The use of ARIKAYCE is not recommended for patients with non-refractory MAC lung disease.
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About Insmed
Insmed Incorporated is a people-first global biopharmaceutical company striving to deliver first- and best-in-class therapies to transform the lives of patients facing serious diseases. The Company is advancing a diverse portfolio of approved and mid- to late-stage investigational medicines as well as cutting-edge drug discovery focused on serving patient communities where the need is greatest. Insmed's most advanced programs are in pulmonary and inflammatory conditions, including a therapy approved in
Headquartered in
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