Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Curr Pharm Des. 2021;27(12):1469-1481. doi: 10.2174/1389201021666201126144057.
Asthma and chronic obstructive pulmonary disease (COPD) are obstructive lung diseases which are characterized by chronic inflammation and an increase in mucus production, and are highly prevalent conditions. Despite recent advances and multiple available therapies, there remains a significant unmet medical need. Over the past 40 years, the introduction of new classes of safe and effective therapy is insufficient. In spite of the high burden of asthma and COPD among patients, there are fewer new approved therapies in comparison to cardiovascular, metabolic and neurological diseases due to few drug candidates and a higher failure rate in the development of respiratory medicine. Lung diseases are amongst the leading causes of death globally with asthma being one of the most prevalent respiratory diseases, which affects people of all ages but, despite effective therapies available, many patients are poorly controlled and have a low quality of life. COPD is currently ranked as the fourth cause of death worldwide and predicted to become the third leading cause of death in 2030. The development of more effective treatments is urgently needed in order to reduce the high mortality rate and the enormous suffering from asthma and COPD. Various inhalation devices with different classes of medications are the foundation as therapies in both asthma and COPD. This article gives a comprehensive review of the promising inhaled therapies in the treatment of asthma and COPD. However, the lack of disease control in asthma and COPD patients may be due to numerous reasons. The association between non-adherence to guidelines on the part of the health care provider and poor inhalation technique and/or non-adherence to the prescribed treatment plan by the patients is common. It is therefore essential to discuss the different delivery systems and the methods used in asthma and COPD patients.
哮喘和慢性阻塞性肺疾病(COPD)是阻塞性肺部疾病,其特征为慢性炎症和黏液分泌增加,且为高度流行疾病。尽管最近取得了进展并出现了多种可用疗法,但仍存在重大的未满足医疗需求。在过去的 40 年中,新型安全有效的治疗方法的引入不足。尽管哮喘和 COPD 在患者中负担沉重,但与心血管、代谢和神经疾病相比,新批准的疗法较少,这是由于候选药物较少以及呼吸医学开发中的失败率较高所致。肺部疾病是全球导致死亡的主要原因之一,哮喘是最常见的呼吸道疾病之一,影响所有年龄段的人,但尽管有有效的治疗方法,许多患者仍控制不佳,生活质量较低。COPD 目前是全球第四大死因,预计到 2030 年将成为第三大死因。为了降低高死亡率和哮喘与 COPD 带来的巨大痛苦,迫切需要开发更有效的治疗方法。各种具有不同类别的药物的吸入装置是哮喘和 COPD 治疗的基础。本文全面回顾了在哮喘和 COPD 治疗中具有前景的吸入疗法。然而,哮喘和 COPD 患者的疾病控制不佳可能有多种原因。医护人员不遵守指南、患者吸入技术差和/或不遵守处方治疗方案的情况很常见。因此,讨论不同的输送系统以及在哮喘和 COPD 患者中使用的方法非常重要。