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Nebulized Therapies in COPD: Past, Present, and the Future

International journal of chronic obstructive pulmonary disease, 2020-01, Vol.15, p.1665-1677 [Peer Reviewed Journal]

COPYRIGHT 2020 Dove Medical Press Limited ;COPYRIGHT 2020 Dove Medical Press Limited ;2020. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2020 Barjaktarevic and Milstone. 2020 Barjaktarevic and Milstone. ;ISSN: 1178-2005 ;ISSN: 1176-9106 ;EISSN: 1178-2005 ;DOI: 10.2147/COPD.S252435 ;PMID: 32764912

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  • Title:
    Nebulized Therapies in COPD: Past, Present, and the Future
  • Author: Barjaktarevic, Igor Z ; Milstone, Aaron P
  • Subjects: Aerosols ; Analysis ; Caregivers ; Chronic obstructive lung disease ; Chronic obstructive pulmonary disease ; copd ; Cost control ; Drug dosages ; Drug therapy ; inhaler ; Inhalers ; Innovations ; Lung diseases, Obstructive ; Lungs ; Muscle strength ; nebulizer ; Particle size ; Pathophysiology ; Patients ; Pharmaceutical industry ; Powders ; Powders (Particulate matter) ; Respiratory agents ; Respiratory system agents ; Revefenacin ; Review
  • Is Part Of: International journal of chronic obstructive pulmonary disease, 2020-01, Vol.15, p.1665-1677
  • Description: Current guidelines recommend inhalation therapy as the preferred route of drug administration for treating patients with chronic obstructive pulmonary disease (COPD). Inhalation devices consist of nebulizers and handheld inhalers, such as dry-powder inhalers (DPIs), pressurized metered-dose inhalers (pMDIs), and soft mist inhalers (SMIs). Although pMDIs, DPIs and SMIs may be appropriate for most patients with COPD, certain patient populations may have challenges with these devices. Patients who have cognitive, neuromuscular, or ventilatory impairments (and receive limited assistance from caregivers), as well as those with suboptimal peak inspiratory flow may not derive the full benefit from handheld inhalers. A considerable number of patients are not capable of producing a peak inspiratory flow rate to overcome the internal resistance of DPIs. Furthermore, patients may have difficulty coordinating inhalation with device actuation, which is required for pMDIs and SMIs. However, inhalation devices such as spacers and valved holding chambers can be used with pMDIs to increase the efficiency of aerosol delivery. Nebulized treatment provides patients with COPD an alternative administration route that avoids the need for inspiratory flow, manual dexterity, or complex hand-breath coordination. The recent approval of two nebulized long-acting muscarinic antagonists has added to the extensive range of nebulized therapies in COPD. Furthermore, with the availability of quieter and more portable nebulizer devices, nebulization may be a useful treatment option in the management of certain patient populations with COPD. The aim of this narrative review was to highlight recent updates and the treatment landscape in nebulized therapy and COPD. We first discuss the pathophysiology of patients with COPD and inhalation device considerations. Second, we review the updates on recently approved and newly marketed nebulized treatments, nebulized treatments currently in development, and technological advances in nebulizer devices. Finally, we discuss the current applications of nebulized therapy in patients with COPD.
  • Publisher: London: Dove Medical Press Limited
  • Language: English
  • Identifier: ISSN: 1178-2005
    ISSN: 1176-9106
    EISSN: 1178-2005
    DOI: 10.2147/COPD.S252435
    PMID: 32764912
  • Source: GFMER Free Medical Journals
    PubMed Central
    DOVE Medical Press Journals
    ProQuest Central
    DOAJ Directory of Open Access Journals
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