For the first time in history, people living with a stubborn and exhausting lung disease finally have a dedicated treatment. After more than two hundred years of waiting, US regulators have given the green light to Brinsupri — a once-a-day pill developed by Insmed Inc. — to treat bronchiectasis, a condition that can quietly steal a person’s ability to breathe with ease.
Bronchiectasis is a strange mix of damage and inflammation. The airways widen and lose their normal shape, making it harder for the lungs to push out mucus. This thick buildup becomes a breeding ground for bacteria, and what follows can be months of repeated infections, fatigue, and hospital visits. For many patients, even walking up the stairs feels like a marathon.
Up until now, there wasn’t much to offer beyond piecemeal solutions: antibiotics to chase away the latest infection or heavy, vibrating vests designed to shake loose the mucus — a tool borrowed from cystic fibrosis care. The disease was first described in the early 1800s by a French doctor, but somehow, no medicine had been specifically approved to treat it. Insmed’s CEO, Will Lewis, has a blunt description for it: “a heart attack of the lungs.”
Around half a million Americans have been diagnosed, but the real number is likely higher. Symptoms often get mistaken for asthma, COPD, or lingering respiratory infections. That makes the new drug not just a breakthrough in treatment, but also an invitation to look more closely at who might be living with the condition without knowing it.
For Insmed, this approval is a big moment. The New Jersey–based biotech already has one rare lung disease treatment on the market — Arikayce — but Brinsupri could be the company’s blockbuster. When Lewis took the helm 13 years ago, the firm had little more than a few months of financial runway. “The street thought it was worth zero,” he says now, half-laughing. “I figured I couldn’t make it worse.”
The tide began to turn in May 2024, when a late-stage trial showed that brensocatib — Brinsupri’s chemical name — significantly cut the number of yearly flare-ups for patients. That meant fewer weeks of being short of breath, fewer days tethered to hospital beds. Investors noticed. Insmed’s stock price has climbed more than fivefold since then, and analysts are already predicting over $1 billion in annual sales by 2027.
For patients, the numbers matter less than the daily relief this pill could bring. Breathing might still be a conscious effort, but with Brinsupri, it could become a little easier — and life could open up again in ways that, until now, were out of reach.