Brensoacatib is a novel dipeptidyl peptidase 1 (DPP1) inhibitor that provides an innovative treatment option for patients with bronchiectasis. This drug exerts therapeutic effects by inhibiting neutrophil mediated inflammatory responses, and has clinical advantages in improving lung function and reducing acute exacerbations. The following elaborates on the key clinical application points from the aspects of mechanism of action, indications, and medication regimen.

1. Mechanism of action

(1) Specifically inhibits DPP1 enzyme activity and blocks neutrophil serine protease activation.

(2) Reduce the release of pro-inflammatory factors such as neutrophil elastase and protease G.

(3) Reduce the level of airway inflammation and improve the pathological process of bronchiectasis.

2 Indications

(1) Maintenance treatment for adult bronchiectasis.

(2) Suitable for moderate to severe patients with frequent acute exacerbations (≥ 2 times per year).

(3) Combination standard treatment is required (such as bronchodilators, mucolytic agents).

3 Usage and Dosage

(1) Recommended dosage: 10mg orally once daily.

(2) Swallow the whole tablet, it can be taken with food or taken alone.

(3) Duration of treatment: At least 24 weeks, long-term efficacy needs to be evaluated individually.

4. Medication for special populations

(1) Liver dysfunction: Mild to moderate without adjustment, use with caution in severe cases.

(2) Renal insufficiency: creatinine clearance rate ≥ 30mL/min does not require adjustment.

(3) Elderly patients: Those aged 65 years or older need to strengthen monitoring of adverse reactions.

5 Adverse Reaction Management

(1) Common: headache, cough, nasopharyngitis.

(2) Key focus: Periodontal diseases (with an incidence rate of approximately 15%).

(3) Suggest baseline oral examination and strengthen oral care during treatment.

6 Drug Interactions

(1) Combined use with potent CYP3A4 inducers may reduce therapeutic efficacy.

(2) Caution should be exercised when using CYP3A4 substrates with narrow therapeutic windows.

(3) Proton pump inhibitors do not affect their absorption.