The field of bronchiectasis had been previously unexplored, but recent studies have shed light on the mechanisms behind the disease pathophysiology. This has led to the shaping of a competitive market for potential treatments.

In recent years, bronchiectasis has garnered a significant amount of attention, with pharmaceutical companies prioritising their investments towards the development of promising pipeline agents to treat the disease by various mechanisms of action (MOAs). Through these agents, pharma companies are now racing to be the first with market authorisation in the field, and the expected completion of clinical studies will determine the shape of the future competitive landscape.

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Pharmaceutical companies involved in the field of bronchiectasis include Insmed, Boehringer Ingelheim, Sanofi, Renovion and Armata Pharmaceuticals.

Mis and under-diagnosis are frequently seen in bronchiectasis patients, making it a challenging disease for which to develop treatments. But ongoing research has now revealed mechanisms that are implicated in the development and progression of bronchiectasis, such as inflammation, further uncovering potential targets for pharmaceutical companies. Such targets include neutrophil-mediated inflammation components but also general inflammation components, such as interleukins and bacteriophages. These targets have been identified by multiple pharmaceutical companies, which are currently competing for future authorisation in the field of bronchiectasis treatment.

Recent achievements include positive trial results for Insmed’s brensocatib

Interestingly, the pipeline landscape is filled with Phase I and Phase II agents, with only Insmed’s brensocatib in Phase III. These pipeline agents have varied MOAs racing against each other to be proven effective. Recent achievements by pharma companies include the announcement of positive results from clinical trials for Insmed’s brensocatib and the Phase II clinical trial of Boehringer Ingelheim’s BI-1291583 against bronchiectasis, which according to clinicaltrials.gov has been completed. Other therapies with expected clinical study completions include Armata’s AP-PA02, in July 2024 (primary completion date); Chiesi’s CHF-6333, expected in June 2025 (primary completion date) and Sanofi’s itepekimab, with a primary completion date of March 2026. All are in Phase II studies for the treatment of bronchiectasis.

GlobalData has also identified important deals, including a licensing agreement between Chiesi Group and Haisco Pharmaceutical for the development, manufacture and commercialisation of HSK-31858, announced in 2023, and a licensing agreement between Insmed and AstraZeneca, announced in 2016, that provides Insmed with global exclusive rights to brensocatib (formerly known as AZD7986). Both these deals are directly related to the bronchiectasis field and will impact the nature of its competition. In addition, both agreements support the clinical trial progression of their respective pipeline agents and establish alliances that could lead to dominance of the bronchiectasis field — dependent on the demonstration of efficacy, safety and tolerability in the studied agents.

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