Summary of COVID-19 brensocatib studies

1. Keir et al., Dipeptidyl peptidase-1 inhibition in patients hospitalised with COVID-19: a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial

404 patient brensocatib late treatment RCT: 41% higher mortality (p=0.02) and 39% worse 7-point scale results (p=0.007).
RCT 406 hospitalized COVID-19 patients in the UK showing higher mortality and worse clinical status with brensocatib (DPP-1 inhibitor) vs. placebo. Although blood neutrophil elastase activity was reduced, indicating the desired pharmacological effect, the results show worse clinical outcomes. Authors hypothesize that inhibiting DPP-1 and neutrophil serine proteases may have negatively impacted the delicate balance of neutrophils' protective and deleterious effects in the immune response to SARS-CoV-2.
Dec 2022, The Lancet Respiratory Medicine, https://www.sciencedirect.com/science/article/pii/S2213260022002612, https://c19p.org/keir