FDA Approves Brensocatib as First Treatment for Non-Cystic Fibrosis Bronchiectasis

The FDA has approved oral brensocatib (Brinsupri) for adults and children 12+ with non-cystic fibrosis bronchiectasis. As a first-in-class reversible DPP-1 inhibitor, it targets the disease’s underlying inflammation, which can cause permanent lung damage and affects about 500,000 people in the U.S.

BRINSUPRI is the first and only FDA-approved treatment for NCFB, giving hundreds of thousands of patients and clinicians across the U.S. an option to manage this chronic and progressive disease that can lead to permanent lung damage and lung function decline.

“This FDA approval represents a potential paradigm shift in how we approach non-cystic fibrosis bronchiectasis,” said Doreen Addrizzo-Harris, M.D., FCCP, the Fiona and Stanley Druckenmiller Professor of Pulmonary, Critical Care and Sleep Medicine at NYU Grossman School of Medicine and Director of the NYU Langone Health Bronchiectasis and NTM Program, and ASPEN investigator. “For the first time, we have a treatment that directly targets neutrophilic inflammation and addresses a root cause of bronchiectasis exacerbations. Based on the strength of the data and the impact we’ve seen in patients, I believe this could become the new standard in non-cystic fibrosis bronchiectasis care.”

There are approximately 500,000 people in the U.S. diagnosed with NCFB, and it is estimated that millions more are living with this disease globally. Unlike other respiratory diseases that are characterized by airway narrowing, bronchiectasis causes airways to permanently widen, making it harder to clear mucus and bacteria, leading to persistent inflammation and infection. A hallmark of bronchiectasis is frequent exacerbations, or flares, when symptoms worsen, such as coughing, increased mucus, shortness of breath and fatigue.

“Non-cystic fibrosis bronchiectasis deeply affects the lives of people living with this chronic lung condition, impacting both their physical health and emotional well-being,” added Elisha Malanga, Executive Director of the Bronchiectasis and NTM Association. “Many patients experience frequent flares, which can disrupt daily life and potentially lead to disease progression. The FDA approval of brensocatib represents a significant and long-awaited advancement as the first approved therapy for non-cystic fibrosis bronchiectasis. Our hope is that treatments like this will enable people with bronchiectasis to manage their condition.”

This approval is based on data from the Phase 3 ASPEN and Phase 2 WILLOW studies, which were both published in the New England Journal of Medicine. In ASPEN, patients taking BRINSUPRI 10 mg or 25 mg had a 21.1% and 19.4% reduction in annual rate of exacerbations respectively, as compared to placebo. Both dosage strengths of BRINSUPRI also met several exacerbation-related secondary endpoints, including significantly prolonging the time to first exacerbation and significantly increasing the proportion of patients remaining exacerbation-free over the treatment period. Patients who received BRINSUPRI 25 mg experienced statistically significant less decline in lung function, as measured by forced expiratory volume in one second (FEV₁) after using a bronchodilator, at week 52. The safety of BRINSUPRI was also evaluated in both studies. The most common adverse reactions ≥2% in the ASPEN trial included upper respiratory tract infection, headache, rash, dry skin, hyperkeratosis, and hypertension. The safety profile for adult patients with NCFB in WILLOW was generally similar to ASPEN, except for a higher incidence of gingival and periodontal adverse reactions in WILLOW.

“The FDA approval of the first-ever treatment for non-cystic fibrosis bronchiectasis is a historic milestone for patients and for Insmed,” said Martina Flammer, M.D., MBA, Chief Medical Officer of Insmed. “By keeping patients at the center of everything we do, we have once again delivered a first-in-class medicine for a disease with no prior approved treatments. This is an incredible achievement in medicine. We’re deeply grateful to the patients, providers, and advocates who made this possible – this is just the beginning of what we can accomplish together for this community.”

BRINSUPRI is a first-in-class dipeptidyl peptidase 1 (DPP1) inhibitor, designed to inhibit the activation of enzymes (neutrophil serine proteases) in neutrophils that are key drivers of chronic airway inflammation in NCFB. BRINSUPRI is the first approved therapy to address the underlying inflammatory process of NCFB.

In parallel, applications for brensocatib with the European Medicines Agency (EMA) and the Medicines and Healthcare products Regulatory Agency (MHRA) have been accepted, and the Company plans to file in Japan in 2025. Commercial launches are anticipated in 2026, pending approval in each territory.

BRINSUPRI is now available in the U.S. by prescription through a comprehensive specialty pharmacy network.

About BRINSUPRI™ (brensocatib)

BRINSUPRI™ (brensocatib) is a small molecule, once-daily, oral, reversible inhibitor of dipeptidyl peptidase 1 (DPP1) indicated for the treatment of non-cystic fibrosis bronchiectasis (NCFB) in adult and pediatric patients 12 years of age or older. Brensocatib is designed to inhibit the activation of enzymes (neutrophil serine proteases) in neutrophils that are key drivers of chronic airway inflammation in NCFB. Brensocatib is also being evaluated for its potential role in other neutrophil-mediated diseases.

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MIND Diet Linked to Lower Dementia Risk via Reduced Hippocampal Sclerosis: Study

An autopsy study published in the Journal of American Medical Association revealed that higher adherence to the Mediterranean–Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet was associated with lower odds of hippocampal sclerosis and less dementia at death, suggesting the diet’s protective effect may be partly mediated through reduced hippocampal damage.

Severe neuronal loss and astrogliosis in coronal sections of the mid-hippocampus cornu ammonis 1 or subiculum is known as hippocampal sclerosis (HS). This pathology is linked to dementia, Alzheimer’s disease, and limbic-predominant age-related transactive response DNA-binding protein 43 encephalopathy neuropathological change (LATE-NC). In humans, nothing is known about the relationship between food and HS or HS and LATE-NC. Thus, this study examined the relationship between HS and HS with LATE-NC and the MIND diet.

Autopsied patients from the ongoing Rush Memory and Aging Project cohort research were included in this investigation. Researchers included participants with neuropathological and nutritional data from 2004 to 2024. Analysis of the data was place between April 3, 2024, and May 13, 2025. The average MIND diet scores were calculated using all verified food frequency questionnaires that were given every year for up to 18 years before to death.

Hematoxylin and eosin staining was used to determine the presence of HS, while TDP-43 immunohistochemistry was used to identify the presence of LATE-NC in eight different brain areas. A semiquantitative measure was used to evaluate the degree of hippocampus neuronal loss in a group of 300 patients. The scale ranged from 0, which indicates no neuronal loss, to 5, which is classified as none to mild, moderate, and severe neuronal loss.

Of the 809 participants (mean [SD] age at death, 91.3 [6.1] years; mean [SD] follow-up, 7.2 [4.4] years; 538 [72%] female; mean [SD] follow-up, 7.2 [4.4] years), 82 (10.1%) had HS; 71 (9%) had both HS and LATE-NC; and in the scored subset, 35 (12%) and 43 (14%) had severe hippocampus neuronal loss.

After adjusting for age at death, sex, education, total calories, APOE-ε4 status, AD, and vascular pathologies, higher MIND diet scores were linked to decreased risks of HS (odds ratio [OR], 0.78; 95% CI, 0.65 to 0.95) and HS with LATE-NC (OR, 0.79; 95% CI, 0.64 to 0.97).

The MIND diet was linked to a 21% indirect connection through HS (β = -0.05; 95% CI, -0.10 to -0.01; P =.02) and a lower incidence of dementia at the time of death (β = -0.26; 95% CI, -0.36 to -0.15; P <.001) in mediation analyses. Less hippocampus neuronal loss was linked to a higher MIND diet score (P for trend =.01).

Overall, MIND diet adherence throughout follow-up was linked to a decreased risk of HS, HS with LATE-NC, and hippocampus neuronal loss in this cohort analysis of autopsied subjects. According to these results, the MIND diet may lessen negative effects on brain health.

Reference:

Agarwal, P., Agrawal, S., Wagner, M., Cherian, L. J., Aggarwal, N. T., James, B. D., Holland, T. M., Bennett, D. A., Barnes, L. L., Leurgans, S. E., & Schneider, J. A. (2025). MIND diet and hippocampal sclerosis among community-based older adults. JAMA Network Open, 8(8), e2526089. https://doi.org/10.1001/jamanetworkopen.2025.26089

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Early Postpartum Contraceptive Implant Placement Safe for Breastfeeding females: Study Finds

USA: Researchers have found in a new study that inserting a contraceptive implant within the first 24 hours postpartum is safe for breastfeeding individuals. This finding supports users, healthcare providers, and hospitals in offering placement at a time that best meets the user’s needs.

The study was published online in the American Journal of Obstetrics and Gynecology on 20 March 2025.

The researchers note that breastfeeding and contraception are vital in patient and public health. The etonogestrel contraceptive implant, a widely used long-acting progestin contraceptive, is highly effective and has few medical restrictions. Although there are concerns that early exposure to exogenous progestin might affect lactation, previous studies have shown that immediate placement does not hinder milk production or long-term breastfeeding. However, no studies have directly compared implant placement within 24 hours of delivery to placement at a later postpartum visit.

To address this, Jamie W. Krashin, Department of Obstetrics & Gynecology, University of New Mexico, Albuquerque, New Mexico, 1 University of New Mexico, 4ACC, Albuquerque, New Mexico, USA, and colleagues examined whether inserting the implant within 24 hours of childbirth affects breastfeeding continuation compared to placement at least two weeks later. Breastfeeding rates were assessed at eight weeks postpartum to determine if timing influenced lactation success.

For this purpose, the researchers conducted a non-inferiority randomized controlled trial at two university hospitals in the Mountain West, enrolling postpartum participants planning to breastfeed and use the etonogestrel implant. Eligible participants, aged 13 or older with term deliveries and no contraindications, were randomly assigned to receive the implant within 24 hours or at least two weeks postpartum. Baseline data were collected through chart reviews and questionnaires, while breastfeeding status and implant use were tracked via electronic surveys at multiple postpartum intervals. The study assessed a 15% non-inferiority margin for breastfeeding at 8 weeks in the per-protocol population.

The study led to the following findings:

  • One-hundred-fifty participants were enrolled (78 in the immediate group and 72 in the delayed group).
  • After excluding 8 participants who declined implant placement, withdrew, or were ineligible, and 16 who lacked primary outcome data, the modified intention-to-treat analysis included 126 participants (69 immediate, 57 delayed).
  • The per-protocol analysis included 115 participants (62 immediate, 53 delayed) after excluding 11 who received the implant outside the designated timeframes.
  • Both groups were similar in age, race, ethnicity, previous breastfeeding experience, delivery mode, and epidural use, but prior implant use was less common in the delayed group (29% vs. 43%).
  • At eight weeks postpartum, 77.4% in the immediate group and 81.1% in the delayed group reported any breastfeeding. The -3.7% difference exceeded the predefined non-inferiority margin, with a lower confidence interval of -16%.
  • In the modified intention-to-treat analysis, the difference between groups was smaller (-0.6%) and within the non-inferiority margin (-12.8% lower confidence limit), with 78.3% in the immediate group and 78.9% in the delayed group reporting any breastfeeding.
  • Implant continuation at 24 weeks was slightly higher in the immediate group (96%) compared to the delayed group (85%), though the difference was not statistically significant.
  • Exclusive or any breastfeeding and implant continuation through 24 weeks were similar between both groups.

The study found no significant differences in breastfeeding or implant continuation between immediate and delayed placement, despite the primary outcome slightly exceeding the non-inferiority margin.

“These findings support the safety and flexibility of initiating the etonogestrel implant at any preferred time postpartum for breastfeeding individuals,” the authors concluded.

Reference:

Krashin, J. W., Rivera-Montalvo, M., Leeman, L., Trujillo, V. Y., Petersen, T. R., Sanchez, D., Bender, E., Carroll, S., Bulleit, E., Alcantara, J., Turok, D. K., Black, P., & Espey, E. (2025). Breastfeeding after immediate versus delayed postpartum contraceptive implant placement: A non-inferiority randomized controlled trial. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2025.03.019

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For eye infections, delayed doctor visits and extent of damage affect vision outcomes: Study

Even though microbial keratitis is a preventable cause of blindness, it’s a complex infection to treat, and many patients have lasting vision impairment.

Previous studies have identified several risk factors for reduced vision after treatment, including delays in symptom onset, longer duration of symptoms and existing eye disease.

However, these studies were restricted to one geographic area or a single type of organism that causes the infection.

In a study published in Ophthalmology, physicians followed 562 patients in the United States and India over a three-month period to identify risk factors that could be easily managed with early intervention.

Maria A. Woodward, M.D., an associate professor of ophthalmology and visual sciences and a member of the Institute for Healthcare Policy and Innovation, answers questions about what causes microbial keratitis, symptoms and preventative measures.

What are the common causes for microbial keratitis?

Woodward: We are surrounded by microorganisms, including Staphylococcus aureus, Streptococcus and fungi, which can get into our eyes through small injuries.

This is a common outcome in patients who do not have good contact lens hygiene or have an underlying eye condition that makes them prone to infections.

Although we don’t know the prevalence rates in the U.S., worldwide it affects over 2 million people per year.

What are symptoms of microbial keratitis?

Woodward: It depends on the infection. Some types of bacterial infections can progress incredibly quickly while fungal infections are slower.

Early symptoms include eye pain, severe eye redness and blurry vision. Some patients also experience light sensitivity.

Unfortunately, many ignore these warning signs and continue to use contact lenses, which can make the problem worse.

If left untreated, the condition causes eye pain and can ultimately penetrate deeper into the eye resulting in scarring and vision loss.

What factors affect treatment for microbial keratitis?

Woodward: The majority of infections in the U.S. are usually treated with antibiotic eye drops.

In our study, we found that if a patient had reduced vision or waited for symptoms to worsen, treatments did not work as well.

Interestingly, we saw that patients in the U.S. who wore contact lenses had slightly better outcomes.

We suspect that their physicians could easily identify what kind of infections are associated with wearing lenses and were able to treat them earlier.

In India, we observed a similar effect in patients with a history of eye trauma.

In rural areas, it’s common for people to get something in their eye that can lead to an infection.

It’s possible that the physicians there knew what kind of infection they might have, given their environment and history, and were able to administer treatments sooner.

What future directions are you excited to pursue?

Woodward: Although this work doesn’t represent everyone globally, we found some commonalities regardless of where the participants were from.

It is important to expand these studies to include factors such as access to medications and adherence to eyedrop regimens.

As part of this work, we took serial photographs of patients over time to monitor how their eye characteristics change over time.

We can use this to help physicians distinguish between mild and severe cases and treat patients effectively.

Reference:

Woodward, Maria A. Factors Associated with Vision Outcomes in Microbial Keratitis, Ophthalmology, DOI: 10.1016/j.ophtha.2025.02.004 

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Dexamethasone Implant Promising as Adjunctive Therapy in Coats’ Disease: Study Finds

Turkey: A retrospective single-center study published in BMC Ophthalmology has highlighted the potential role of intravitreal dexamethasone implants as an adjunctive therapy in managing Coats’ disease alongside conventional ablative treatments. The research, conducted by Ozlem Ural Fatihoglu and colleagues from the Department of Ophthalmology at Dokuz Eylül University, İzmir, Turkey, assessed the efficacy and safety of this approach over a long-term follow-up period.

The study evaluated patients treated between February 2012 and January 2024 who received a dexamethasone (Dex) implant in addition to standard ablative therapy, with a follow-up duration exceeding 12 months. Out of 15 enrolled patients, the analysis included 11 patients. The cohort primarily consisted of males (90.9%) with unilateral disease, while the only female participant presented with bilateral involvement. The mean age at diagnosis was 14.8 years, spanning a wide age range from 2 to 60 years, highlighting the diverse presentation of the disease.

The following were the notable findings of the study:

  • At baseline, 58.3% of the eyes were classified as stage 3a1, 25% as stage 3a2, and 16.7% as stage 2b.
  • Over an average follow-up of nearly 66 months, visual acuity remained stable in 50% of the treated eyes.
  • One-third of the eyes showed measurable improvement of at least one Snellen line.
  • Two eyes demonstrated a two-line gain, while the other two eyes achieved a single-line gain in visual acuity.
  • Vision deteriorated in both eyes during the study period.
  • Transient intraocular pressure (IOP) elevation was observed in 66.7% of treated eyes.
  • Cataract progression occurred in 58.3% of eyes, with one-third requiring cataract surgery.
  • One eye developed a secondary vasoproliferative tumor, necessitating CyberKnife therapy and vitrectomy.
  • No severe implant-related complications were reported, indicating a favorable safety profile for the treatment.

The findings suggest that intravitreal dexamethasone implants may serve as a useful adjunctive option, particularly in pediatric patients, to reduce the need for repeated general anesthesia and in adults with extensive macular exudation, where conventional ablative therapy alone may be insufficient. While the outcomes are promising, the authors acknowledge key limitations, including the retrospective design, small sample size, absence of a control group, and the study’s setting in a tertiary referral center, which may have resulted in a higher proportion of advanced cases.

Despite these limitations, the research highlights the value of dexamethasone implants in achieving anatomical and functional stabilization in Coats’ disease. With half of the treated eyes maintaining stable vision and one-third showing improvement, the study adds evidence supporting the integration of steroid implants into multimodal treatment strategies,” the authors wrote.

They recommend further studies to validate these findings and better define patient subgroups that may benefit most from this adjunctive approach.

Reference:

Ural Fatihoglu, O., Ayhan, Z., Ozturk, T. et al. Place of dexamethasone implant as an adjunctive treatment in Coats’ disease: a retrospective single-center study. BMC Ophthalmol 25, 435 (2025). https://doi.org/10.1186/s12886-025-04279-2

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Imposter Syndrome among Orthopaedic Surgery residents extremely common and disproportionately affects female residents: Study

Imposter syndrome is a psychological phenomenon in which individuals experience persistent self-doubt and feelings of inadequacy despite achieving objective measures of success. This phenomenon is associated with lower job satisfaction, increased rates of burnout, and reduced productivity.

Harsh Wadhwa et al conducted a study to determine the prevalence of imposter syndrome among orthopaedic surgery residents and determine whether specific individual or residency characteristics predict higher rates of imposter syndrome.

The study was performed at the Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California.

An anonymous survey was distributed to residents at 7 ACGME-accredited orthopaedic surgery residencies by the authors. Respondents provided deidentified demographic data and completed the Clance Imposter Phenomenon Scale (CIPS) assessment. CIPS scores were used to categorize imposter syndrome severity as none to mild, moderate, significant, or intense. Differences were calculated and compared using t-test and x2 analyses. Multivariable regression analysis was used to identify predictors of increased symptom severity.

The key findings of the study were:

• One hundred orthopaedic surgery residents completed the survey.

• Forty percent of respondents were female, and the mean age was 30.6 ± 2.8 years.

• The prevalence of significant or intense imposter syndrome was 73%.

• CIPS scores and significant or intense imposter syndrome did not vary by age, gender, sexual orientation, race/ethnicity, level of training, program region, research year, non-MD degrees, and Step 1, Step 2, or Orthopaedic In-Training Examination (OITE) scores on univariable analyses.

• On multivariable analysis, female residents were 5.64 (OR = 5.64 [1.04-30.63]) times more likely to have significant or intense imposter syndrome (p = 0.045).

• Residents at western programs were 0.13 (OR = 0.13 [0.02-0.90]) times as likely to experience significant or intense imposter syndrome (p = 0.039).

• Women (estimate = 8.72 [1.41-16.04]; p = 0.0201) and those with OITE scores in the 0 to 25th (estimate = 11.92 [0.29- 23.54]; p = 0.0446) and 51st-75th (estimate = 12.73 [2.79-22.67]; p = 0.0128) percentiles had higher CIPS scores.

The authors concluded that – “Imposter syndrome is highly prevalent among orthopaedic surgery residents, with significant or intense symptoms affecting 73% of those surveyed. Female gender and lower OITE scores were associated with increased imposter syndrome severity, while training at an orthopaedic surgery residency program in the West was associated with decreased imposter syndrome. Additional research is needed to identify effective interventions to address imposter syndrome and minimize its effects on individuals’ careers. Implementing focused initiatives to address imposter syndrome may help alleviate burnout and promote both career fulfillment and professional growth.”

Further reading:

Imposter Syndrome Among Orthopaedic Surgery Residents is Extremely Common and Disproportionately Affects Female Residents

Harsh Wadhwa et al

JBJS Open Access 2025:e24.00132. http://dx.doi.org/10.2106/JBJS.OA.24.00132

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125 MBBS seats at AIIMS Kalyani Check 2025 admission guidelines, fee, complete details here

Kalyani- All India Institute of Medical Sciences (AIIMS) Kalyani has released a prospectus for admission into the MBBS course for the academic year 2025. The Course of studies leading to the award of Bachelor of Medicine and Bachelor of Surgery (MBBS) of the AIIMS shall last for a minimum of five and a half academic years, including one year’s compulsory internship.

As per the prospectus, a total of 125 seats for Indian nationals are available for admission to the MBBS course. The reservation matrix would be as per the Medical Counselling Committee (MCC) directives. AIIMS Kalyani has an MBBS course divided into three professional divisions, i.e. First, Second and Third Professional MBBS are of one, one and a half and two years duration respectively.

Also Read: AIIMS Kalyani first convocation held, President Murmu asks doctors to promote healthy lifestyle by example

Admitted candidates must attend the Orientation Program and join classes on the stipulated date. The admission of the candidates, who fail to join the Course by the date stipulated in the letter of intimation, shall automatically be cancelled and such seats shall then be offered to the candidates on the waiting list in order of merit in the same category

The candidates selected for admission to the MBBS course at the AIIMS Kalyani, after verification of their eligibility and being offered admission, should bring the following original certificates/ testimonials/documents at the time of admission-

1 Certificate of having passed the 10+2 or equivalent Examinations, showing the subject offered by him/her in the Examination.

2 Certificate from the Board from which he/she passed the High School/Higher Secondary Examination, showing his/her date of birth.

3 Certificate/Mark sheet from the Board from which he/she passed the 10+2 or equivalent Examination showing that he/she has secured 60% or more marks (50% in case of SC/ST/Persons with Benchmark Disability) in aggregate in English, Physics, Chemistry and Biology.

4 Migration Certificate from the University/Board last attended by him/her.

COMPULSORY ROTATORY INTERNSHIP TRAINING

After passing the Final MBBS Examination, all the candidates will be required to do a compulsory internship for a period of one calendar year (12 months) in the hospital and rural health centres recognised by the AIIMS. During the internship period, the interns are allowed a total of 15 days leave in the full term of one year. The degree of MBBS shall be awarded after satisfactory completion of one year’s internship.

FEES & OTHER PAYMENTS

The dues are to be paid in cash immediately, after the candidates have been declared medically fit in the Medical Board of the Institute, as per details given below-

S.NO

ACADEMIC & OTHER FEES

AMOUNT IN RS

1

Registration Fee

25

2

Caution Money

100

3

Tuition Fee

1350

4

Laboratory Fee

90

5

Student Union Fee

63

TOTAL

1628

S.NO

HOSTEL & OTHER FEES

AMOUNT IN RS

1

Hostel Rent*

990

2

Gymkhana Fee

220

3

Pot Fund

1320

4

Electricity Charges

198

5

Mess Security (Refundable)

500

6

Hostel Security (Refundable)

1000

TOTAL

4228

To view the prospectus, click the link below

https://medicaldialogues.in/pdf_upload/aiims-kalyani-mbbs-2025-125-seats-offered-know-complete-admission-rules-fee-structure-297700.pdf

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Flatworms could replace rats for in vivo brain studies

Tiny pond worms could help find new ways to treat schizophrenia, develop an understanding of drug addiction and test new medicines for mental illnesses—all while reducing the number of mice and rats used in early medical research.

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Medical pros of electroconvulsive therapy may be exaggerated while cons are downplayed

The medical pros of electroconvulsive therapy (ECT) are being exaggerated while the risks are being downplayed, suggest the findings of a survey on the type of information patients and their relatives/friends recall having been given before the procedure, and published online in the Journal of Medical Ethics.

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