The future of inhalation therapy in chronic obstructive pulmonary disease

Cazzola, Mario; Ora, Josuel; Calzetta, Luigino; Rogliani, Paola; Matera, Maria Gabriella

doi:10.1016/j.crphar.2022.100092

Cited by 13 publications

(10 citation statements)

References 87 publications

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“…Muscarinic antagonist/β2 agonists (MABAs) are a new class of bronchodilators in development that combine anticholinergic and β2-agonistic mechanisms of bronchodilation into a single molecule [ 77 ]. Batefenterol (GSK961081) is an example that is in clinical development for COPD.…”

Section: Non-cholinergic Targets For Copd Treatmentmentioning

confidence: 99%

Pathophysiology, Therapeutic Targets, and Future Therapeutic Alternatives in COPD: Focus on the Importance of the Cholinergic System

Gomes

Cheng

2023

Biomolecules

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Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by airway limitation and changes in airway structure. It has a high global burden of mortality and morbidity. The etiology of COPD is complex, but exposure to tobacco smoke and other inhaled lung oxidants are major risk factors. Both pharmacological and non-pharmacological approaches are used to manage COPD, but there remains an urgent unmet need for drugs that can modify the course of the disease. This review focuses on the role of acetylcholine and other components of the pulmonary cholinergic system in the pathogenesis of COPD, and the inhaled pharmacological agents that target it. In addition to its role as a neurotransmitter, acetylcholine regulates diverse aspects of COPD pathogenesis including bronchoconstriction, airway remodeling, mucus secretion and inflammation. Inhaled antimuscarinic drugs are a key component of therapy for COPD, as monotherapy or in combination with inhaled β2 agonists or corticosteroids. We review the evidence supporting the use of current anticholinergic agents in COPD and preview novel drugs targeting the cholinergic system and agents from other classes in clinical development, such as phosphodiesterase-4 inhibitors and monoclonal antibodies targeting inflammatory mediators.

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Section: Non-cholinergic Targets For Copd Treatmentmentioning

confidence: 99%

Pathophysiology, Therapeutic Targets, and Future Therapeutic Alternatives in COPD: Focus on the Importance of the Cholinergic System

Gomes

Cheng

2023

Biomolecules

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“…Among LAMAs, apart from revefenacin and glycopyrrolate, Chiesi Farmaceutici worked on developing a nebulized formulation of CHF-5407 , a novel quaternary ammonium salt acting as a potent antagonist of human M3 muscarinic receptors; however, development of this compound has not made significant clinical progress recently [7 ▪▪ ].…”

Section: Reviewmentioning

confidence: 99%

“…Nevertheless, with the development of new drugs, improvement in technology, and recognition of the importance of adequate drug delivery, nebulizers have not only maintained their place in the treatment hierarchy of airway disease but have also proven a vital platform for development of new classes of drugs [7 ▪▪ ,8,9]. Here, we discuss recent advances in nebulized drug delivery in COPD and other airway diseases with an emphasis on the advantages of nebulizer-delivered approaches compared with hand-held inhalers…”

Section: Introductionmentioning

confidence: 99%

Recent advances predict a bright future for nebulizers

Troy

Vleet

Tashkin

2023

Current Opinion in Pulmonary Medicine

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Purpose of reviewWith the improvement in device technology and delivery methods of inhaled medications, along with development of novel compounds and recognition of the importance of personalized approach in the management of chronic airway diseases, nebulizers have not only maintained their place in the treatment hierarchy of airway disease but have also proven a vital platform for the development of new classes of drugs. Recent findingsThis short review explores recent advances in nebulized drug delivery in chronic obstructive pulmonary disease and other chronic airway diseases, emphasizing the progress in nebulizer technology, physiologic advantages of nebulized drug delivery and the high versatility of currently available and developing nebulizer-delivered pharmacotherapies. SummaryVersatility and efficiency of nebulizers allows for a broad spectrum of existing and novel therapies to be clinically studied, facilitating the progress in phenotype-targeted pharmacotherapies in the management of chronic airway diseases Keywords aerosolized drugs, chronic airway disease, chronic obstructive pulmonary disease, nebulizer, novel pharmacotherapies, phenotype && ,8,9]. Here, we discuss recent advances in nebulized drug delivery in COPD and other airway diseases with an emphasis on the advantages of nebulizer-delivered approaches compared with hand-held inhalers.

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“…[21] The current treatment of COPD and asthma is mainly based on different combinations of bronchodilators, inhaled corticosteroids, and antibiotics. [22][23][24] However, pharmacological therapy for COPD typically only addresses symptoms. [25][26][27] Furthermore, in an observational study conducted in Copenhagen, there was low use and adherence to maintenance medications for COPD in the general population, even in severe and very severe COPD cases.…”

Section: The Authors Have No Conflicts Of Interest To Disclosementioning

confidence: 99%

Perceptions of the effectiveness of non-pharmacological management of respiratory disorders among CRD patients

Aldabayan

2023

Medicine

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Chronic respiratory diseases (CRDs) are among the leading cause of mortality worldwide. While pharmacological approaches are commonly used to manage symptoms, non-pharmacological management of CRDs is considered crucial in preventing disease progression and improving patient self-efficacy. To describe the perceived effectiveness of non-pharmacological management of CRDs among CRD patients and determine whether the CRD patients perceptions of the effectiveness of non-pharmacological management are associated with their demographic characteristics. An analytic cross-sectional study design was utilized. The non-pharmacological management practices of CRD patients and their perception of the effectiveness of these therapeutic measures were assessed using a researcher-developed questionnaire. Data collection took place in primary healthcare centers in Al Ahsa, Saudi Arabia from October 2021 to March 2022. The proportion of CRD patients who perceived that non-pharmacological interventions were effective was computed. Binary logistic regression was performed to determine the association between the demographic characteristics of the respondents and their perception of the effectiveness of non-pharmacological management. Among the 390 respondents, 42% perceived that non-pharmacological measures were effective. Half of the respondents believed that smoking cessation, influenza vaccination, improving physical activity, and nutrition support helped alleviate CRD symptoms, while less than half of the respondents considered pulmonary rehabilitation, educational programs, and oxygen therapy effective measures to control symptoms. Women were found to be 3.24 times more likely to perceive non-pharmacological interventions as effective (P < .0000) compared to men. Those with university-level education were 66.6% less likely to consider non-pharmacological interventions to be effective (P < .0000) than those who completed preuniversity-level education. Age and marital status did not significantly influence perceptions of effectiveness. Differences in the perceptions of the effectiveness of various non-pharmacological measures to alleviate CRD symptoms existed among the CRD patients of Al Ahsa. The perception of effectiveness was significantly associated with the patient’s gender and educational attainment.

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The future of inhalation therapy in chronic obstructive pulmonary disease

Cited by 13 publications

References 87 publications

Pathophysiology, Therapeutic Targets, and Future Therapeutic Alternatives in COPD: Focus on the Importance of the Cholinergic System

Pathophysiology, Therapeutic Targets, and Future Therapeutic Alternatives in COPD: Focus on the Importance of the Cholinergic System

Recent advances predict a bright future for nebulizers

Perceptions of the effectiveness of non-pharmacological management of respiratory disorders among CRD patients

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