Efficacy and safety of brensocatib in Japanese patients with non-cystic fibrosis bronchiectasis: Analysis of the ASPEN trial

BACKGROUND: In the ASPEN trial (NCT04594369), brensocatib 10 mg and 25 mg significantly reduced the burden of pulmonary exacerbations (annualized rate [primary endpoint], time to first, proportion exacerbation-free) over 52 weeks vs placebo in patients with bronchiectasis; brensocatib 25 mg significantly reduced lung function decline and nominally significantly improved patient-reported symptoms. Here we report efficacy and safety for Japanese patients. METHODS: Adults with bronchiectasis with ≥2 exacerbations in the 12 months before screening were randomized to once-daily brensocatib (10 mg or 25 mg) or placebo for 52 weeks. Endpoints included annualized exacerbation rate, time to first exacerbation, proportion remaining exacerbation-free, change from baseline in lung function, severe exacerbation rate, and change from baseline in patient-reported symptoms. RESULTS: Baseline characteristics of Japanese patients (n = 87) were generally consistent across groups. Brensocatib 10 mg and 25 mg reduced the annualized exacerbation rate vs placebo (rate ratio, 0.37 [95 % CI, 0.16-0.87]; 0.32 [0.14-0.75]), prolonged time to first exacerbation, and increased odds of remaining exacerbation-free. The annualized severe exacerbation rate was lower with brensocatib 10 mg and 25 mg vs placebo (rate ratio, 0.11 [0.01-1.04]; 0.30 [0.06-1.62]). Brensocatib, particularly at the 25 mg dose, also reduced lung function decline vs placebo (LS mean difference: forced expiratory volume in 1 s, 97 mL [95 % CI, 32-162]; forced vital capacity, 164 mL [84-244]) and improved patient-reported symptoms. Adverse events were similar across groups. CONCLUSIONS: Consistent with overall ASPEN results, brensocatib 10 mg and 25 mg reduced exacerbation frequency vs placebo in Japanese patients with bronchiectasis. Lung function, patient-reported symptoms, and safety data were consistent with overall ASPEN trial results. CLINICAL TRIAL REGISTRATION: NCT04594369.