Smyth Hugh D C
University of North Carolina at Chapel Hill, School of Pharmacy, NC 27599, USA.
Expert Opin Drug Deliv. 2005 Jan;2(1):53-74. doi: 10.1517/17425247.2.1.53.
The current market for pulmonary drug delivery is at a bottleneck. The therapeutic advantages of inhalation aerosols, and the potential for the lungs as a route for systemically acting drugs, vaccines and gene therapeutic agents, have resulted in a rapid growth of the industry. Alongside this, the environment of inhaler design and formulation has changed markedly in recent years. Environmental concerns over propellants, the commercial success of dry powder inhalers, and the apparent lack of advancement of propellant-driven metered-dose inhalers (pMDIs) has led to a less clear future for these devices. This review critically assesses these pressures and also potential opportunities for the pMDI. It is proposed that the future role of pMDIs will be determined by several important forces that can be classified under 'technology development' or 'market climate' categories. Technology development forces will be strengthened by the ability of the industry to have a systematic understanding of mechanisms of spray formation, perform subsequent and continued device and formulation advances, and a focus on all patient groups: particularly paediatric and geriatric populations. The ability to succeed in these areas will be largely determined by the willingness to invest in fundamental research of pMDI technologies.
当前肺部药物递送市场正处于瓶颈期。吸入气雾剂的治疗优势，以及肺部作为全身作用药物、疫苗和基因治疗药物给药途径的潜力，推动了该行业的快速发展。与此同时，近年来吸入器设计和制剂的环境发生了显著变化。对推进剂的环境担忧、干粉吸入器的商业成功，以及推进剂驱动的定量吸入器（pMDIs）明显缺乏进展，使得这些设备的未来前景变得不明朗。本综述批判性地评估了这些压力以及pMDIs的潜在机遇。有人提出，pMDIs的未来作用将由几股重要力量决定，这些力量可归类为“技术发展”或“市场环境”类别。行业若能系统理解喷雾形成机制、持续推进设备和制剂研发，并关注所有患者群体，尤其是儿科和老年人群体，技术发展力量将得到加强。在这些领域取得成功的能力很大程度上取决于对pMDI技术基础研究的投资意愿。
