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“This multi-modality strategy has long been the standard for other chronic diseases, such as congestive heart failure, and bronchiectasis warrants an equally nuanced approach.” Dr PJ McShane  In a recent editorial published by Dr. Pamela McShane of the National Institutes of Health (NIH), she describes brensocatib, now marketed as BRINSUPRI™, as a breakthrough for the bronchiectasis community. This first-in-class DPP-1 inhibitor marks an important step forward in reducing inflammation and exacerbations for people living with bronchiectasis. However, Dr. McShane emphasizes that it is unrealistic to expect one drug to meet every patient’s needs. Instead, she encourages both clinicians and patients to view BRINSUPRI™ as part of a broader treatment plan that includes mucoactive agents, airway-clearance techniques, and, when appropriate, macrolide therapy. Where BRINSUPRI™ Fits in the Treatment LandscapeFor individuals already receiving long-term macrolide therapy, adding BRINSUPRI™ may further improve outcomes by targeting inflammation through a different mechanism. For those living with nontuberculous mycobacterial (NTM) infections, where macrolide therapy may not be possible due to resistance concerns, a DPP-1 inhibitor such as BRINSUPRI™ could represent an alternative strategy to interrupt the ongoing cycle of inflammation, infection, and mucus dysfunction that drives bronchiectasis progression. Evidence from the WILLOW StudyDr. McShane referenced findings from a subgroup analysis of the WILLOW study, where participants with Pseudomonas aeruginosa infection experienced a significant reduction in exacerbations when treated with brensocatib compared with placebo. This suggests that BRINSUPRI™ could benefit patients with chronic bacterial colonization, one of the most challenging aspects of managing bronchiectasis. The Importance of Multi-Mechanism StrategiesDuring her guest appearance at a Bronchiectasis and NTM Association support group, Dr. McShane reiterated that while DPP-1 inhibitors represent an exciting advance, they do not address every biological mechanism involved in bronchiectasis. She emphasized that future therapies must also target airway-epithelial health, mucus viscosity, and host-pathogen interactions to achieve long-term improvement. Dr. McShane also compared this approach to the multi-modality treatments already used for other chronic diseases such as congestive heart failure. Bronchiectasis, she argued, deserves an equally comprehensive and individualized model that combines medications, airway clearance, exercise, and infection control for the best outcomes. BRINSUPRI™ represents a long-awaited milestone, but it is only the beginning. The future of bronchiectasis management depends on integrated, multi-mechanism treatment plans that address both airway inflammation and mucus dysfunction, two central challenges of this complex condition. Editorial Reference:P.J. McShane. Are Dipeptidyl Peptidase-1 Inhibitors the Future Anti-inflammatory Treatment in Bronchiectasis? Archivos de Bronconeumología. DOI: 10.1016/j.arbres.2025.09.002
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The past several days have been nothing short of inspiring for the bronchiectasis and NTM community.  Between new research updates, clinical insights, and groundbreaking treatment news, we have so much to be hopeful about! It all began with a powerful video from Dr. Charles Daley of National Jewish Health, who was speaking with a patient group in Florida. His focus? The newly FDA-approved medication for bronchiectasis: Brensocatib (brand name BRINSUPRI™). Why This MattersFor decades, people living with bronchiectasis have had limited treatment options beyond airway clearance and antibiotics. The FDA’s approval of Brensocatib marks the first new therapy specifically approved for non-CF bronchiectasis, and the ripple effects are already being felt in the bronchiectasis care centers across the country. Dr. Daley explained that at National Jewish Health, clinicians will begin prescribing Brensocatib to patients who are most likely to benefit—including those who struggle with chronic infections like nontuberculous mycobacteria (NTM). Even more importantly, NJH will collect data from these patients to help determine the drug’s long-term effectiveness across different subgroups. A Standout FindingWhat truly lit up the conversation was one of the most exciting results from the pivotal clinical trial:
A New Chapter of HopeThese updates (see video for complete talk) remind us that the field of bronchiectasis care is finally moving forward. We are not standing still. From clinical trials to FDA approval to real-world prescribing, there is momentum, hope, and possibility taking shape. For patients, caregivers, and clinicians alike, this is the beginning of a new chapter—one where the words “stable lung function” carry the promise of more time, more strength, and more opportunities to live fully. Click to learn more about BE CLEAR resources, including the book and individual consultations. Many people have been asking about ARINA-1, a promising proprietary nebulized solution in development for bronchiectasis.  To get the latest, I reached out to Dan Copeland, CEO of Renovion, Inc., the company leading this innovative work. What is ARINA-1?ARINA-1 is an investigational, at-home nebulized therapy designed to:
Clinical TrialsEarly clinical results suggest ARINA-1 begins working within days and delivers promising outcomes. If approved, it could become the first non-antibiotic nebulized therapy specifically for bronchiectasis—addressing a critical unmet need for patients.
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AuthorLinda Cooper Esposito, MPH is a health educator with bronchiectasis. She developed the BE CLEAR Method to Living with Bronchiectasis and writes with compassion and humor about this chronic lung disease. Archives
November 2025
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