Comment on: Inhaled antimicrobial therapy—Barriers to effective treatment, by J. Weers, Inhaled antimicrobial therapy — Barriers to effective treatment, Adv. Drug Deliv. Rev. (2015), http://dx.doi.org/10.1016/j.addr.2014.08.013

Cipolla, David; Froehlich, Juergen; Gonda, Igor

doi:10.1016/j.addr.2015.04.015

Cited by 4 publications

(6 citation statements)

References 6 publications

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“…Lipoquin can therefore be administered once-daily [9] and was tested in a Phase 2a trial in adult CF patients: Lipoquin demonstrated an increase in lung function (FEV1) of 6.9% from baseline in an adult CF population ( Figure 1) and additionally showed a significant reduction in the colony forming units (CFUs) of PA in the sputum of these patients. This is in contrast to several recent trials with other inhaled antibiotics which did not demonstrate an improvement in lung function in adult CF patients who comprise an ever increasing percentage of the aging CF population: TOBI® and Tobi Podhaler® (Novartis Pharmaceuticals Corp.), Cipro DPI® (Bayer), and Colobreathe® (Forest) [4].…”

contrasting

confidence: 51%

“…A twice-daily inhaled dry powder formulation of ciprofloxacin [25] is also being evaluated in two phase 3 trials in NCFB; some of these patients are infected with microorganisms other than PA. Both Pulmaquin and Cipro DPI contain ciprofloxacin and provide slow release of the drug [9,26] which may be beneficial to improve tolerability and safety [4,27]. …”

Section: Non-cystic Fibrosis Bronchiectasis With Pseudomonas Aeruginomentioning

confidence: 99%

“…Some patients may respond better to a different class of antibiotic (e.g., quinolones) due to poor tolerability or suboptimal effectiveness of current treatment options [4]. Mixing or rotating antibiotics with different mechanisms of action has been used in clinical practice with the hope for better patient outcome [5].…”

mentioning

confidence: 99%

“…In addition to liposomes, solid lipid nanoparticles are another example of a formulation innovation that could be applied to an existing antibiotic to modify its drug release characteristics [7]. Two such formulations are in development, liposomal amikacin [8] and liposomal ciprofloxacin [4,9]. Liposomal amikacin (ARIKAYCE®, Insmed) inhaled once-daily, met the noninferiority primary endpoint of relative change in FEV1 from baseline to end of study (Day 168) compared to tobramycin (TOBI®, Novartis), inhaled twice-daily [8] in a population of CF patients.…”

mentioning

confidence: 99%

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Emerging Opportunities for Inhaled Antibiotic Therapy

Cipolla¹,

Froehlich²,

Gonda³

2015

J Antimicro

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Inhaled antibiotics have become a mainstay of cystic fibrosis (CF) therapy by providing high drug concentrations locally in the lung while minimizing systemic exposure and thus the potential for side effects. In CF, inhaled antibiotics decrease the rate of decline of lung function, improve the quality of life, and reduce the frequency of exacerbations and hospital admissions. However, the burden of therapy remains high in CF. There is an opportunity for more convenient and effective inhaled antibiotics to reduce the disease burden in CF. In contrast, despite the unmet medical need, no inhaled antibiotics are approved for lung infections in a number of other diseases including non-CF bronchiectasis, COPD, melioidosis, pneumonic plague, anthrax, Q fever, tularemia and patients with other infections including non-tuberculous mycobacteria. This review discusses the progress towards achieving that goal in those indications. Additionally, the approved inhaled antibiotics in CF are only available as a fixed dose that is inhaled twice or thrice daily. There is a limited opportunity to personalize therapy to the patient. This review envisions a future scenario where the treatment of lung infections can be optimized to the specific needs of each individual based on the attributes of their infectious agents.

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contrasting

confidence: 51%

Section: Non-cystic Fibrosis Bronchiectasis With Pseudomonas Aeruginomentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Emerging Opportunities for Inhaled Antibiotic Therapy

Cipolla¹,

Froehlich²,

Gonda³

2015

J Antimicro

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“…(6, 9). However, inhalation of high-dose powders could cause local side effects such as cough and throat irritation (1, 3, 10). Fine drug particles produced by conventional jet-milling are often cohesive with poor flow and dispersion properties (11).…”

Section: Introductionmentioning

confidence: 99%

How Much Surface Coating of Hydrophobic Azithromycin Is Sufficient to Prevent Moisture-Induced Decrease in Aerosolisation of Hygroscopic Amorphous Colistin Powder?

Zhou

Loh²,

et al. 2016

AAPS J

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Aerosolisation performance of hygroscopic particles of colistin could be compromised at elevated humidity due to increased capillary forces. Co-spray drying colistin with a hydrophobic drug is known to provide a protective coating on the composite particle surfaces against moisture-induced reduction in aerosolisation performance; however, the effects of component ratio on surface coating quality and powder aerosolisation at elevated relative humidities are unknown. In this study, we have systematically examined the effects of mass ratio of hydrophobic azithromycin on surface coating quality and aerosolisation performance of the co-spray dried composite particles. Four combination formulations with varying drug ratios were prepared by co-spray drying drug solutions. Both of the drugs in each combination formulation had similar in vitro deposition profiles, suggesting that each composite particle comprise two drugs in the designed mass ratio, which is supported by XPS and ToF-SIMS data. XPS and ToF-SIMS measurements also revealed that 50 % by weight (or 35 % by molecular fraction) of azithromycin in the formulation provided a near-complete coating of 96.5 % (molar fraction) on the composite particle surface, which is sufficient to prevent moisture-induced reduction in FPFrecovered and FPFemitted. Higher azithromycin content did not increase coating coverage, while contents of azithromycin lower than 20 %w/w did not totally prevent the negative effects of humidity on aerosolisation performance. This study has highlighted that a critical amount of azithromycin is required to sufficiently coat the colistin particles for short-term protection against moisture.

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Inhaled liposomal ciprofloxacin in patients with non-cystic fibrosis bronchiectasis and chronic lung infection with Pseudomonas aeruginosa (ORBIT-3 and ORBIT-4): two phase 3, randomised controlled trials

Haworth

Bilton

Chalmers

et al. 2019

The Lancet Respiratory Medicine

157

139

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Comment on: Inhaled antimicrobial therapy—Barriers to effective treatment, by J. Weers, Inhaled antimicrobial therapy — Barriers to effective treatment, Adv. Drug Deliv. Rev. (2015), http://dx.doi.org/10.1016/j.addr.2014.08.013

Abstract: CommentaryComment on: Inhaled antimicrobial therapy-Barriers to effective treatment, by J. Weers, Inhaled antimicrobial therapy -Barriers to effective treatment, Adv. Drug Deliv. Rev. (2015), http://dx.

Cited by 4 publications

References 6 publications

Emerging Opportunities for Inhaled Antibiotic Therapy

Emerging Opportunities for Inhaled Antibiotic Therapy

How Much Surface Coating of Hydrophobic Azithromycin Is Sufficient to Prevent Moisture-Induced Decrease in Aerosolisation of Hygroscopic Amorphous Colistin Powder?

Inhaled liposomal ciprofloxacin in patients with non-cystic fibrosis bronchiectasis and chronic lung infection with Pseudomonas aeruginosa (ORBIT-3 and ORBIT-4): two phase 3, randomised controlled trials

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