Brensocatib: a new entry in the dm+d
The NHS Business Services Authority has added brensocatib to the dm+d dictionary (version 8.0.0). Brensocatib is a dipeptidyl peptidase I (DPP-I) inhibitor — a selective enzyme inhibitor used in the management of chronic bronchiectasis.
What is brensocatib used for?
Brensocatib is indicated to reduce airway infections and exacerbations in patients with bronchiectasis. It works by preserving neutrophil elastase activity, which helps improve lung clearance and reduce bacterial colonisation. The standard dose is 25 mg orally twice daily.
Event-medicine relevance
Brensocatib is a maintenance therapy for chronic bronchiectasis, not an acute rescue medication. It has no rapid onset of action and is not suitable for field administration in acute respiratory distress. You are most likely to encounter it in a patient’s medication history if they have known bronchiectasis and attend a medical event.
If a patient on brensocatib presents with acute respiratory exacerbation or signs of acute infection, escalate to hospital care promptly. Do not delay transfer awaiting continuation of their regular therapy — acute management takes priority.
Key cautions and side effects
Common side effects include diarrhoea, nausea, abdominal pain, headache, and upper respiratory tract infection.
Serious adverse effects to be aware of:
- Severe diarrhoea or colitis
- Hepatotoxicity (liver function should be monitored)
- Hypersensitivity reactions
Important cautions:
- Avoid in severe hepatic impairment; use with caution in renal impairment
- Active gastrointestinal disease or diarrhoea is a contraindication
- Limited safety data in pregnancy and breast-feeding
- Live vaccines should be avoided during treatment
Brensocatib has no major interactions with common event-medicine drugs (analgesics, antihistamines, corticosteroids). However, caution is advised if the patient is taking other hepatically metabolised drugs and has impaired liver function.