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拉丁美洲慢性阻塞性肺疾病管理中的挑战与机遇:吸入疗法和先进药物递送系统综述

Challenges and Opportunities in COPD Management in Latin America: A Review of Inhalation Therapies and Advanced Drug Delivery Systems.

作者信息

Izquierdo-Condoy Juan S, Salazar-Santoliva Camila, Salazar-Duque Daniel, Palacio-Dávila Yorlenis-Del-Carmen, Hernández-Londoño Juan M, Orozco-Gonzalez Rafael, Rodríguez-Sánchez María-Silvana, Marín-Bedoya Valentina, Loaiza-Guevara Valentina

机构信息

One Health Research Group, Universidad de las Americas, Quito 170137, Ecuador.

Facultad de Medicina, Fundación Universitaria Autónoma de Las Américas, Pereira 660001, Colombia.

出版信息

Pharmaceutics. 2024 Oct 11;16(10):1318. doi: 10.3390/pharmaceutics16101318.

Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries, where it poses a significant burden. In Latin America, the estimated prevalence of COPD is notably high, but the management and treatment of the disease have progressed slowly. This review examines the current status of inhalation therapy for COPD in Latin America, focusing on pharmacological therapies, inhalation devices, and the potential of advanced drug delivery systems. Pharmacological management predominantly relies on inhaled bronchodilators and corticosteroids, though access to these therapies varies considerably across the region. Inhalation devices, such as metered-dose inhalers (MDIs) and dry powder inhalers (DPIs), play a critical role in effective treatment delivery. However, their usage is often compromised by incorrect technique, low adherence, and limited availability, especially for DPIs. Emerging technologies, including nanoformulations, represent a promising frontier for the treatment of COPD by improving drug delivery and reducing side effects. However, significant barriers, such as high development costs and inadequate infrastructure, hinder their widespread adoption in the region. This review highlights the need for a multifaceted approach to enhance COPD management in Latin America, including optimizing access to existing inhalation therapies, strengthening healthcare infrastructure, improving provider training, and engaging patients in treatment decisions. Overcoming these challenges is crucial to improving COPD outcomes across the region.

摘要

慢性阻塞性肺疾病(COPD)是全球发病和死亡的主要原因,在低收入和中等收入国家尤其如此,在这些国家它构成了重大负担。在拉丁美洲,COPD的估计患病率显著较高,但该疾病的管理和治疗进展缓慢。本综述探讨了拉丁美洲COPD吸入治疗的现状,重点关注药物治疗、吸入装置以及先进药物递送系统的潜力。药物管理主要依赖吸入性支气管扩张剂和皮质类固醇,不过该地区获得这些治疗的情况差异很大。吸入装置,如定量吸入器(MDIs)和干粉吸入器(DPIs),在有效递送治疗中起着关键作用。然而,其使用常常因技术不正确、依从性低和可获得性有限而受到影响,尤其是DPIs。包括纳米制剂在内的新兴技术通过改善药物递送和减少副作用,为COPD的治疗展现了一个有前景的领域。然而,诸如高开发成本和基础设施不足等重大障碍阻碍了它们在该地区的广泛应用。本综述强调需要采取多方面方法来加强拉丁美洲的COPD管理,包括优化获得现有吸入治疗的途径、加强医疗基础设施、改善医疗服务提供者培训,以及让患者参与治疗决策。克服这些挑战对于改善该地区COPD的治疗效果至关重要。

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