Brinsupri Drug Information
Generic name: BRENSOCATIB
Uses of Brinsupri
BRINSUPRI is indicated for the treatment of non-cystic fibrosis bronchiectasis (NCFB) in adult and pediatric patients 12 years of age and older.
Dosage & Administration of Brinsupri
Recommended Dosage
The recommended dosage of BRINSUPRI is as follows: 10 mg orally once daily with or without food or 25 mg orally once daily with or without food Missed Dose(s) Patients who miss a dose should take the next dose at their regular time the next day. Do not double the dose to make up for the missed dose.
Side Effects of Brinsupri
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The safety data below reflect the safety of BRINSUPRI in adult and pediatric patients aged 12 years and older with non-cystic fibrosis bronchiectasis (NCFB). A total of 1721 patients with NCFB were randomized in a double-blind, placebo-controlled clinical trial of 52 weeks duration (ASPEN).
The safety of BRINSUPRI was based on data from 1719 adult and pediatric patients aged 12 years and older who received at least one dose of BRINSUPRI or placebo. A total of 1156 patients received at least one dose of BRINSUPRI 10 mg or 25 mg orally once daily. Table 1 shows the adverse reactions occurring at an incidence of ≥2% and higher in BRINSUPRI-treated patients compared to placebo in the safety population from ASPEN.
Table 1 Adverse Reactions with BRINSUPRI with an Incidence of ≥2% and More Common than Placebo in ASPEN s in WILLOW A total of 256 adult patients with NCFB were randomized in the 24-week, double-blind, placebo-controlled clinical trial (WILLOW). The safety profile for adult patients with NCFB in WILLOW was generally similar to ASPEN, with the exception of a higher incidence of gingival and periodontal adverse reactions. Less Common Adverse Reactions Liver Function Test Elevations In ASPEN, there was an increase from baseline in average ALT, AST, and alkaline phosphatase levels at all time points from Week 4 through Week 56 in both BRINSUPRI 10 mg and 25 mg arms compared to placebo.
| Adverse Reaction | Placebo (N=563) n (%) | BRINSUPRI 10 mg QD (N=582) n (%) | BRINSUPRI 25 mg QD (N=574) n (%) |
|---|---|---|---|
| Upper respiratory tract infection Upper respiratory tract infection includes coronavirus infection, COVID-19, influenza, upper respiratory tract infection, viral infection, and viral upper respiratory tract infection. | 141 (25) | 157 (27) | 169 (29) |
| Headache | 39 (7) | 39 (7) | 49 (9) |
| Rash Rash includes rash, rash maculo-papular, rash pruritic, rash erythematous, dermatitis, and erythema. | 22 (4) | 25 (4) | 35 (6) |
| Dry skin Dry skin includes dry skin, chapped lips, cheilitis, lip dry, skin exfoliation, skin fissures, xeroderma, and xerosis. | 8 (1) | 17 (3) | 25 (4) |
| Hyperkeratosis Hyperkeratosis includes hyperkeratosis, palmoplantar keratoderma, and skin hypertrophy. | 5 (1) | 8 (1) | 16 (3) |
| Hypertension | 17 (3) | 28 (5) | 13 (2) |
Warnings & Cautions for Brinsupri
Dermatologic Adverse Reactions Treatment with BRINSUPRI is associated with an increase in dermatologic adverse reactions, including rash, dry skin, and hyperkeratosis. Monitor patients for development of new rashes or skin conditions and refer patients to a dermatologist for evaluation of new dermatologic findings.
Gingival and Periodontal Adverse Reactions Treatment with BRINSUPRI is associated with an increase in gingival and periodontal adverse reactions. Refer patients to dental care services for regular dental checkups while taking BRINSUPRI. Advise patients to perform routine dental hygiene.
Live Attenuated Vaccines
The concomitant use of BRINSUPRI and live attenuated vaccines has not been evaluated. It is unknown whether administration of live attenuated vaccines during BRINSUPRI treatment will affect the safety or effectiveness of these vaccines. The use of live attenuated vaccines should be avoided in patients receiving BRINSUPRI.
Pregnancy Safety for Brinsupri
Pregnancy Risk Summary There are no available data on BRINSUPRI use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes. In animal embryo fetal development (EFD) studies, oral administration of brensocatib to pregnant rats during organogenesis at maternal exposures 128 times the maximum recommended human dose (MRHD) on an AUC basis was associated with malformations. Oral administration of brensocatib to pregnant rabbits during organogenesis demonstrated no adverse developmental effects at doses that produced maternal exposures up to 20 times the MRHD.
No adverse development effects were observed after oral administration of brensocatib to pregnant rats from the period of organogenesis through lactation at doses that produced maternal exposures 17 times the MRHD on an AUC basis (see Data ). The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes.
In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is respectively. The malformation of bent scapula was observed at a maternal dose of 100 mg/kg/day (128 times the MRHD on an AUC basis). There were no adverse findings at maternal oral doses of 20 mg/kg/day (42 times the MRHD on an AUC basis).
Brensocatib was not associated with adverse effects on the fetus at maternal exposures up to 20 times the MRHD on an AUC basis. Maternal toxicity as indicated by reductions in body weight gain and food consumption was noted at maternal doses of 15 mg/kg/day and greater (greater than 5 times the MRHD on an AUC basis).
Pediatric Use of Brinsupri
Pediatric Use The safety and effectiveness of BRINSUPRI for the treatment of NCFB have been established in pediatric patients aged 12 years and older. Use of BRINSUPRI for this indication is supported by evidence from an adequate and well-controlled trial (ASPEN), which enrolled 41 pediatric patients aged 12 years and older, and additional pharmacokinetic data in pediatric patients aged 12 to 17 years. Common adverse reactions in pediatric patients aged 12 years and older enrolled in ASPEN were consistent with those in adults.
The safety and effectiveness of BRINSUPRI have not been established in pediatric patients younger than 12 years of age.
Overdosage Information for Brinsupri
Consider contacting the Poison Help line (1-800-222-1222) or a medical toxicologist for overdose management recommendations.
Clinical Studies of Brinsupri
The efficacy of BRINSUPRI was evaluated in two randomized, double-blind, placebo-controlled, parallel-group, multicenter, multinational clinical trials (ASPEN and WILLOW ). WILLOW was a 24-week trial that included 256 adult patients with NCFB who were randomized to BRINSUPRI 10 mg (n=82), BRINSUPRI 25 mg (n=87), or placebo (n=87) administered orally once daily. In both ASPEN and WILLOW, all adult patients had a history of confirmed NCFB by chest computed tomography with at least 2 documented pulmonary exacerbations (PEx) prior to screening in the past 12 months.
In ASPEN, pediatric patients 12 years of age and older had at least one PEx in the prior 12 months. Demographics and baseline characteristics of patients in ASPEN and WILLOW are provided in Table 2. Table 2 Demographics and Baseline Characteristics of Patients in ASPEN and WILLOW 329 40 ASPEN The primary efficacy endpoint in ASPEN was the annualized rate of PEx over the 52-week treatment period.
Pulmonary exacerbations were defined as worsening of 3 or more of the following major symptoms over 48 hours: increased cough, increased sputum volume or change in sputum consistency, increased sputum purulence, increased breathlessness, decreased exercise tolerance, fatigue and/or malaise, and hemoptysis, resulting in a healthcare provider's decision to prescribe systemic antibiotics. Pulmonary exacerbations were considered severe if requiring treatment with intravenous antibacterial drugs and/or resulted in hospitalization. Table 3 provides the results of the annualized rate of PEx, and the results of the key secondary endpoints in ASPEN of time to first PEx, proportion of patients remaining exacerbation free throughout the 52-week treatment period, annualized rate of severe PEx, and the change from baseline in post-bronchodilator FEV 1.
| ASPEN (N=1721) | WILLOW (N=256) | |
|---|---|---|
| Abbreviations: N, number of patients in the intent-to-treat analysis set; n, number of patients; PEx, pulmonary exacerbations; pp, percent predicted; FEV 1, forced expiratory volume in 1 second; SD, standard deviation | ||
| Age (years), mean (SD) | 60 (16) | 64 (12) |
| Female n (%) | 1107 (64) | 174 (68) |
| White n (%) | 1266 (74) | 225 (88) |
| Black or African American n (%) | 10 (1) | 4 (2) |
| Asian n (%) | 191 (11) | 23 (9) |
| Hispanic or Latino n (%) | 511 (30) | 6 (2) |
| ≥3 PEx in prior 12 months n (%) | 502 (29) | 84 (33) |
| Former smoker n (%) | 510 (30) | 86 (34) |
| ppFEV 1 post-bronchodilator, mean (SD) | 74 (23) | 68 (24) |
| Sputum positive for Pseudomonas aeruginosa n (%) | 607 (35) | 89 (35) |
| Chronic macrolide therapy n (%) | 329 (19) | 40 (16) |
| Placebo (N=563) | BRINSUPRI 10 mg (N=583) | BRINSUPRI 25 mg (N=575) | |
|---|---|---|---|
| Abbreviations: FEV 1, forced expiratory volume in 1 second; LS, least squares; PEx, pulmonary exacerbation | |||
| Annualized Rate of PEx | 1.29 | 1.02 | 1.04 |
| Rate Ratio (95% CI) | -- | 0.79 (0.68, 0.92) | 0.81 (0.69, 0.94) |
| Median Time to First PEx (weeks) | 36.71 | 49.00 | 50.71 |
| Hazard Ratio (95% CI) | -- | 0.81 (0.70, 0.95) | 0.83 (0.70, 0.97) |
| Proportion of Patients that were PEx Free at Week 52 (%) | 40.3 | 48.5 | 48.5 |
| Odds Ratio (95% CI) | -- | 1.41 (1.11, 1.81) | 1.40 (1.10, 1.79) |
| Annualized Rate of Severe PEx | 0.19 | 0.14 | 0.14 |
| Rate Ratio (95% CI) | -- | 0.74 (0.51, 1.09) | 0.74 (0.52, 1.06) |
| LS Mean Change from Baseline in Post-Bronchodilator FEV 1 (mL) at Week 52 | -62 | -50 | -24 |
| Difference vs Placebo (95% CI) | -- | 11 (-14, 37) | 38 (11, 65) |
Drug information sourced from the FDA. This content is for informational purposes only and does not constitute medical advice. Consult a healthcare professional before making any medication decisions.
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