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Brensocatib

Phase 3

Covid19 | Small molecule | Infectious Disease |Insmed Incorporated|Last Updated: Mar 12, 2026

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment406

FDA Designations

PRIORITY_REVIEWBREAKTHROUGH_THERAPY

Clinical trial landscape

Brensocatib · 13 trials · 9 indications

Phase 3 2Phase 2 3Phase 1 8
NCT04817332STOP-COVID19: Superiority Trial Of Protease Inhibition in COVID-19Covid19
COMPLETED406 Analytics
NCT04594369A Study to Assess the Efficacy, Safety, and Tolerability of Brensocatib in Participants With Non-Cystic Fibrosis BronchiectasisNon-Cystic Fibrosis Bronchiectasis
COMPLETED1,767 Analytics
PHASE3COMPLETED
STOP-COVID19: Superiority Trial Of Protease Inhibition in COVID-19
Covid19Unlock trial analytics
PHASE3COMPLETED
A Study to Assess the Efficacy, Safety, and Tolerability of Brensocatib in Participants With Non-Cystic Fibrosis Bronchiectasis
Non-Cystic Fibrosis BronchiectasisUnlock trial analytics

Study Endpoints

Primary Endpoints

Comparison of Participant Clinical Status Between Treatment Arms
Up to 29 days

To determine the participant clinical status on a 7-point ordinal scale, minimum value 1, maximum value 7. Higher values indicate a worse outcome: 1. Not hospitalised, no limitations on activities 2. Not hospitalised, limitation on activities; 3. Hospitalised, not requiring supplemental oxygen; 4. Hospitalised, requiring supplemental oxygen; 5. Hospitalised, on non-invasive ventilation or high flow oxygen devices; 6. Hospitalised, on invasive mechanical ventilation or Extracorporeal membrane oxygenation (ECMO) 7. Death.

Annualized Rate of Pulmonary Exacerbations (PEs)
Up to Week 52

PE was defined as having 3 or more of these symptoms for at least 48 hours resulting in a physician's decision to prescribe antibiotics: 1. Increased cough 2. Increased sputum volume or change in sputum consistency 3. Increased sputum purulence 4. Increased breathlessness and/or decreased exercise tolerance 5. Fatigue and/or malaise 6. Hemoptysis. A severe pulmonary exacerbation was that required intravenous (IV) antibacterial drug treatment and/or hospitalization. A minimum of 14 days must have occurred between one exacerbation onset and the next. Any exacerbation that occurred less than 14 days from the prior exacerbation was not considered a new exacerbation. Independent adjudication committee with pulmonary physicians adjudicated reported PE events to see if they fulfil the protocol definition. The rate of PE was analyzed using the negative binomial model.

Change From Baseline to the 28-day Average of Daily Sinus Total Symptom Score (sTSS) at Week 24
Baseline and Week 24
Maximum Plasma Concentration (Cmax) of Brensocatib on Day 1
Predose and 0.5, 1, 2, 4, 6, 8, and 24 hours postdose on Day 1
Cmax of Brensocatib on Day 28
Predose and at 0.5, 1, 2, 4, 6, 8, 24, and 168 hours postdose on Day 28
Time to Maximum Plasma Concentration (Tmax) of Brensocatib on Day 1
Predose and 0.5, 1, 2, 4, 6, 8, and 24 hours postdose on Day 1
Tmax of Brensocatib on Day 28
Predose and at 0.5, 1, 2, 4, 6, 8, 24, and 168 hours postdose on Day 28
Area Under the Concentration-time Curve From Time 0 to 24 Hours Postdose (AUC0-24) of Brensocatib in Plasma on Day 1
Predose and 0.5, 1, 2, 4, 6, 8, and 24 hours postdose on Day 1
AUC0-24 of Brensocatib in Plasma on Day 28
Predose and at 0.5, 1, 2, 4, 6, 8, and 24 hours postdose on Day 28
Elimination Half-life (t1/2) of Brensocatib in Plasma on Day 28
Predose and at 0.5, 1, 2, 4, 6, 8, 24, and 168 hours postdose on Day 28
Number of Participants Who Experienced at Least One Treatment-emergent Adverse Event (TEAE)
Up to Day 56

A TEAE is defined as any adverse event (AE) that occurred after the first dose of study investigational medicinal product (IMP) and within 28 days after the last dose of study IMP.

Time to the First Pulmonary Exacerbation Over 24-Week Treatment Period
Baseline (Day 1) to Week 24

Time to first pulmonary exacerbation was calculated as the number of days from the date of randomization to the date of first documentation of an exacerbation. Pulmonary exacerbation was defined as having 3 or more of the following symptoms for at least 48 hours resulting in a physician's decision to prescribe antibiotics: 1. Increased cough 2. Increased sputum volume or change in sputum consistency 3. Increased sputum purulence 4. Increased breathlessness and/or decreased exercise tolerance 5. Fatigue and/or malaise 6. Hemoptysis A minimum of 4 weeks must have occurred between one exacerbation onset and the next. Any exacerbation that occurred less than 4 weeks from the prior exacerbation was not considered a new exacerbation. The analysis was performed using the stratified log rank test and using Kaplan Meier (KM) curves.

Relative Bioavailability Between Brensocatib Pediatric Oral Solution and Oral Tablets for Area Under the Concentration-time Curve from Time 0 Extrapolated to Infinity (AUC∞) of Brensocatib in Plasma
Pre-dose and at multiple timepoints post-dose on Days 1 and 10

Pharmacokinetics of brensocatib following a single dose in healthy participants will be assessed.

Number of Participants With High Acceptability to Each Brensocatib Formulation Based on Palatability Assessments Measured by the 9-point Hedonic Scale
Day 1
Area Under the Plasma Concentration-time Curve (AUC) of Brensocatib
Pre-dose and at multiple timepoints post-dose on Days 1 to 8, and Days 13 to 20

The effect of clarithromycin on the single dose pharmacokinetics of brensocatib will be assessed in healthy participants.

Parts 1 and 2: Area Under the Concentration-time (AUC) of Brensocatib in Plasma
Pre-dose and at multiple timepoints post-dose on Days 1 to 7, 17 (Part 1), and Days 1 to 7, 12 to 18 (Part 2)

Pharmacokinetics of brensocatib following a single dose in healthy participants will be assessed.

Area Under the Concentration Time Curve (AUC)
Pre-dose and at multiple timepoints post-dose on Days 1 to 9

Comparison of the pharmacokinetics of a single dose of brensocatib in participants with hepatic impairment to that in matched healthy control participants with normal hepatic function.

Part 1: Number of Participants who Experienced at least one Treatment-Emergent Adverse Event (TEAE) as Assessed by Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE v5.0)
Up to Day 7
Part 2: Placebo- and Baseline-Corrected QTcF (ΔΔQTcF)
Pre-dose and at multiple timepoints post-dose on Days 1 to 4 in each period
Area Under the Concentration Time Curve (AUC) of Brensocatib in Plasma
Pre-dose and at multiple timepoints post-dose on Day 1 up to maximum Day 14

Pharmacokinetics of brensocatib following a single dose in healthy participants will be assessed.

AUC∞ Plasma Brensocatib/Plasma Total Radioactivity Ratio Calculated as AUC∞ of Plasma Brensocatib Relative to AUC∞ of Plasma Total Radioactivity
Pre-dose and at multiple timepoints post-dose on Day 1 up to maximum Day 14
AUC∞ Blood/Plasma Total Radioactivity Ratio Calculated as AUC∞ of Whole Blood Total Radioactivity to AUC∞ of Plasma Total Radioactivity
Pre-dose and at multiple timepoints post-dose on Day 1 up to maximum Day 14
Amount Excreted in Urine (Aeu) of Brensocatib
Pre-dose and at multiple timepoints post-dose on Day 1 up to maximum Day 14
Total Radioactivity Expressed as Amount of [14C]-brensocatib Excreted in Urine
Pre-dose and at multiple timepoints post-dose on Day 1 up to maximum Day 14
Total Radioactivity Expressed as Amount of [14C]-brensocatib Excreted in Feces (Aef)
Pre-dose and at multiple timepoints post-dose on Day 1 up to maximum Day 14
Area Under the Plasma Concentration Time Curve (AUC) of Brensocatib
Pre-dose and at multiple timepoints post-dose on Days 1 to 14

Pharmacokinetics of brensocatib following a single dose will be assessed in participants with renal impairment and in healthy participants.

Maximum Observed Plasma Concentration (Cmax) of Brensocatib
Pre-dose and at multiple timepoints post-dose on Days 1 to 14
Time to Reach Maximum Observed Plasma Concentration (Tmax) of Brensocatib
Pre-dose and at multiple timepoints post-dose on Days 1 to 14
Number of Participants who Experienced at Least one Adverse Event (AE)
Up to Day 14

Determination of the safety and tolerability of a single dose of brensocatib in participants with impaired renal function and in healthy participants.

Secondary Endpoints

Improvement of One Category From Admission Using 7-point Ordinal Scale.
Day 29
Participant Clinical Status on 7-point Ordinal Scale
Day 15
Mean Change in the 7-point Ordinal Scale
Baseline to days 3, 5, 8, 11 and 29
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
BrensocatibEXPERIMENTALBrensocatib oral tablet, 25mg once per day for 28 days
PlaceboPLACEBO_COMPARATORPlacebo oral tablet, 25mg once per day for 28 days
Brensocatib 10 milligrams (mg)EXPERIMENTALParticipants will receive brensocatib 10 mg, tablets orally, once daily, for 52 weeks.
Brensocatib 25 mgEXPERIMENTALParticipants will receive brensocatib 25 mg, tablets orally, once daily, for 52 weeks.
Brensocatib 40 mgEXPERIMENTALParticipants will receive brensocatib 40 mg tablet, orally, QD for 24 weeks along with mometasone furoate nasal spray (MFNS) by nasal route as background therapy at a stable dose according to the Investigator's discretion and local guidance.
Brensocatib 10 mgEXPERIMENTALParticipants will receive brensocatib 10 mg tablet, orally, QD for 24 weeks along with MFNS by nasal route as background therapy at a stable dose according to the Investigator's discretion and local guidance.
Brensocatib Treatment Sequence ABEXPERIMENTALParticipants will receive a single dose of the pediatric oral brensocatib solution (Treatment A) on Day 1 followed by a washout period of 9 days. On Day 10, participants will receive a single dose of the oral brensocatib tablet (Treatment B).
Brensocatib Treatment Sequence BAEXPERIMENTALParticipants will receive a single dose of the oral brensocatib tablet (Treatment B) on Day 1 followed by a washout period of 9 days. On Day 10, participants will receive a single dose of the pediatric oral brensocatib solution (Treatment A).
Brensocatib Treatment Sequence ADBCEXPERIMENTALParticipants will taste and expectorate Dose 1 of each brensocatib formulation across the 4 treatment administrations (Treatments A, B, C, and D), orally on Day 1 in the sequence ADBC.
Brensocatib Treatment Sequence BACDEXPERIMENTALParticipants will taste and expectorate Dose 1 of each brensocatib formulation across the 4 treatment administrations (Treatments A, B, C, and D), orally on Day 1 in the sequence BACD.
Brensocatib Treatment Sequence CBDAEXPERIMENTALParticipants will taste and expectorate Dose 1 of each brensocatib formulation across the 4 treatment administrations (Treatments A, B, C, and D), orally on Day 1 in the sequence CBDA.
Brensocatib Treatment Sequence DCABEXPERIMENTALParticipants will taste and expectorate Dose 1 of each brensocatib formulation across the 4 treatment administrations (Treatments A, B, C, and D), orally on Day 1 in the sequence DCAB.
Brensocatib + ClarithromycinEXPERIMENTALParticipants will receive a single oral dose of brensocatib in the morning on Days 1 and 13 after an overnight fast, and oral doses of clarithromycin, twice daily (BID), with food on Days 8 to 19. On Day 13, brensocatib will be coadministered with the morning dose of clarithromycin. Clarithromycin can be taken with food, with the exception of the morning dose on the day of coadministration with brensocatib (Day 13), which will be taken after an overnight fast.
Part 1: Period 1: BrensocatibEXPERIMENTALPeriod 1: Participants will receive a single oral dose of brensocatib on Day 1 in Part 1 of the study.
Part 1: Period 2: Brensocatib + RifampinEXPERIMENTALPeriod 2: Participants will receive rifampin 600 mg once daily (QD), orally, on Days 8 to 23 along with a single oral dose of brensocatib prior to the rifampin administration on Day 17 in Part 1 of the study.
Part 2: Period 1: BrensocatibEXPERIMENTALPeriod 1: Participants will receive a single oral dose of brensocatib on Day 1 in Part 2 of the study.
Part 2: Period 2: Brensocatib + EsomeprazoleEXPERIMENTALPeriod 2: Participants will receive esomeprazole 40 mg QD, orally, on Days 8 to 12 along with a single oral dose of brensocatib prior to the esomeprazole administration on Day 12 in Part 2 of the study.
Cohort 1: BrensocatibEXPERIMENTALHealthy participants with normal hepatic function will receive single oral dose of brensocatib on Day 1 under fasted conditions. Healthy participants will be matched within the protocol criteria to one or more participants with hepatic impairment.
Cohort 2: BrensocatibEXPERIMENTALParticipants with mild hepatic impairment will receive single oral dose of brensocatib on Day 1 under fasted conditions.
Cohort 3: BrensocatibEXPERIMENTALParticipants with moderate hepatic impairment will receive single oral dose of brensocatib on Day 1 under fasted conditions.
Cohort 4: BrensocatibEXPERIMENTALParticipants with severe hepatic impairment will receive single oral dose of brensocatib on Day 1 under fasted conditions.
Part 1: Treatment Dose 1EXPERIMENTALParticipants (in a 3:1 ratio) will receive a single oral dose of brensocatib Dose 1 or placebo, once on Day 1.
Part 1: Treatment Dose 2EXPERIMENTALParticipants (in a 3:1 ratio) will receive a single oral dose of brensocatib Dose 2 or placebo, once on Day 1.
Part 2EXPERIMENTALParticipants will be randomized to 1 of 4 treatment sequences (ABCD, BDAC, CADB, DCBA).
[14C]-brensocatibEXPERIMENTALHealthy participants will receive single oral dose of \[14C\]-brensocatib on Day 1 under fasted conditions.
Cohort 1 (Mild Impairment): BrensocatibEXPERIMENTALParticipants with mild renal impairment will receive single oral dose of brensocatib on Day 1 under fasted conditions.
Cohort 2 (Moderate Impairment): BrensocatibEXPERIMENTALParticipants with moderate renal impairment will receive single oral dose of brensocatib on Day 1 under fasted conditions.
Cohort 3 (Severe Impairment): BrensocatibEXPERIMENTALParticipants with severe renal impairment will receive single oral dose of brensocatib on Day 1 under fasted conditions.
Cohort 4 (Normal): BrensocatibEXPERIMENTALHealthy participants with normal renal function will receive single oral dose of brensocatib on Day 1 under fasted conditions. Healthy participants will be matched within the protocol criteria to one or more participants with renal impairment.

Interventions

NameTypeDescription
BrensocatibDRUGSelective, competitive, and reversible inhibitor of DPP1
PlaceboDRUGMatched placebo
Brensocatib 10 mgDRUGOral tablet.
Brensocatib 25 mgDRUGOral tablet.
Mometasone furoate nasal spray (MFNS)DRUGNasal spray suspension.
Brensocatib Oral SolutionDRUGBrensocatib solution
Brensocatib Oral TabletDRUGBrensocatib tablet
ClarithromycinDRUGOral tablets.
RifampinDRUGOral capsules.
EsomeprazoleDRUGOral capsules.
MoxifloxacinDRUGOral tablet.
[14C]-brensocatibDRUGOral solution.
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Eligibility Criteria

Age Range16 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites16

Inclusion Criteria: 6.1. Inclusion criteria • Male or female * ≥16 years of age * SARS-CoV-2 infection (clinically suspected+ or laboratory confirmed\*). * Admitted to hospital as in-patient less than 96 hours prior to randomisation\^ * Illness of any duration, and at least one of the following: ...

Countries:United KingdomUnited StatesArgentinaAustraliaAustriaBelgiumBrazilBulgariaCanadaChileColombiaDenmarkFranceGermanyGreeceHungaryIrelandIsraelItalyJapanLatviaMalaysiaMexicoNetherlandsNew ZealandPeruPolandPortugalSerbiaSlovakiaSouth KoreaSpainTaiwanThailandTurkey (Türkiye)UkraineCzechiaSingapore
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Frequently asked questions about Brensocatib

What is Brensocatib used for?

Brensocatib is an investigational small molecule being developed by Insmed Incorporated for non-cystic fibrosis bronchiectasis, chronic rhinosinusitis without nasal polyps, and cystic fibrosis. It is also studied in healthy volunteers and in hepatic impairment. It is not approved and remains in clinical development.

Who makes Brensocatib?

Brensocatib is developed by Insmed Incorporated, a biopharmaceutical company traded on NASDAQ under the ticker INSM. The drug is an investigational small molecule in clinical development for respiratory and ENT conditions.

What phase is Brensocatib in?

Brensocatib is in Phase 2 clinical development. It has received FDA Priority Review and Breakthrough Therapy designations. The drug is not approved and is still being studied in clinical trials.

What clinical trials is Brensocatib in?

Brensocatib has four completed Phase 1 trials in healthy volunteers: NCT05652257, NCT05826574, NCT05965570, and NCT06178783. These studies evaluated absorption, metabolism, excretion, drug interactions, and palatability of oral formulations.

Is Brensocatib the same as other drugs?

Brensocatib is a distinct investigational small molecule developed by Insmed. No alternative names are provided. It is being studied for non-cystic fibrosis bronchiectasis, chronic rhinosinusitis without nasal polyps, and cystic fibrosis.