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Zhang C, D'Angelo D, Buttini F, Yang M. Long-acting inhaled medicines: Present and future. Adv Drug Deliv Rev 2024; 204:115146. [PMID: 38040120 DOI: 10.1016/j.addr.2023.115146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
Inhaled medicines continue to be an essential part of treatment for respiratory diseases such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis. In addition, inhalation technology, which is an active area of research and innovation to deliver medications via the lung to the bloodstream, offers potential advantages such as rapid onset of action, enhanced bioavailability, and reduced side effects for local treatments. Certain inhaled macromolecules and particles can also end up in different organs via lymphatic transport from the respiratory epithelium. While the majority of research on inhaled medicines is focused on the delivery technology, particle engineering, combination therapies, innovations in inhaler devices, and digital health technologies, researchers are also exploring new pharmaceutical technologies and strategies to prolong the duration of action of inhaled drugs. This is because, in contrast to most inhaled medicines that exert a rapid onset and short duration of action, long-acting inhaled medicines (LAIM) improve not only the patient compliance by reducing the dosing frequency, but also the effectiveness and convenience of inhaled therapies to better manage patients' conditions. This paper reviews the advances in LAIM, the pharmaceutical technologies and strategies for developing LAIM, and emerging new inhaled modalities that possess a long-acting nature and potential in the treatment and prevention of various diseases. The challenges in the development of the future LAIM are also discussed where active research and innovations are taking place.
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Affiliation(s)
- Chengqian Zhang
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Davide D'Angelo
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark; Food and Drug Department, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - Francesca Buttini
- Food and Drug Department, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - Mingshi Yang
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark; Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road No. 103, 110016, Shenyang, China.
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Lin YR, Wu FY, Xiao H, Huang JL, Gong BB, Li YL, Lu N, Jiang XH, Sun QX, Zhang JF, Hu JT, Zhao YX, Li CQ. Mycobacterium vaccae Nebulization in the Treatment of COVID-19: A Randomized, Double-Blind, Placebo-Controlled Trial. J Aerosol Med Pulm Drug Deliv 2021; 34:108-114. [PMID: 33691499 DOI: 10.1089/jamp.2020.1628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 infection is associated with strong infectiousness and has no effective therapy. We aimed to explore the efficacy and safety of Mycobacterium vaccae nebulization in the treatment of Coronavirus Disease 2019 (COVID-19). Methods: In this randomized, double-blind, placebo-controlled clinical trial, we included 31 adult patients with moderate COVID-19 who were admitted to the Fourth People's Hospital of Nanning (Nanning, China) between January 22, 2020 and February 17, 2020. Patients were randomly divided into two groups: group A (standard care group) and group B (M. vaccae in combination with standard care group). The primary outcome was the time interval from admission to viral RNA negative conversion (oropharyngeal swabs were used in this study). Secondary outcomes included chest computed tomography (CT), mortality, length of hospital stay, complications during treatment, and so on. Patients were followed up to 4 weeks after discharge (reexamination of viral RNA, chest CT, etc.). Results: Nucleic acid test negative conversion time in group B was shorter than that in group A (2.9 days [2.7-8.7] vs. 6.8 days [3.3-13.8]; p = 0.045). No death and no conversion to severe or critical cases were observed in both groups. Two weeks after discharge, neither "relapse" nor "return to positive" cases were found. Four weeks after discharge, it was found that there was no case of " relapse " or "return to positive" in group B, and 1 patient in group A showed "return to positive", but there was no clinical manifestation and imaging progression. No adverse reactions related to M. vaccae were found during observation period. Conclusion: M. vaccae treatment might shorten the time interval from admission to viral RNA negative conversion, which might be beneficial to the prevention and treatment of COVID-19. Clinical Trial Registration: ChiCTR2000030016.
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Affiliation(s)
- Yan-Rong Lin
- Department of Respiratory and Critical Care Medicine, The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Feng-Yao Wu
- Department of Respiratory and Critical Care Medicine, The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Huan Xiao
- Department of Respiratory Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Jian-Lin Huang
- Department of Respiratory Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Bei-Bei Gong
- Department of Respiratory and Critical Care Medicine, The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - You-Ling Li
- Department of Respiratory and Critical Care Medicine, The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Ning Lu
- Department of Respiratory and Critical Care Medicine, The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Xiao-Hong Jiang
- Department of Respiratory Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Qi-Xiang Sun
- Department of Respiratory Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Jian-Feng Zhang
- Department of Emergency, Guangxi Medical University, Nanning, Guangxi, China
| | - Jun-Tao Hu
- Department of Respiratory Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yong-Xiang Zhao
- Collaborative Innovation Center for Targeting Tumor Theranostics, Guangxi Medical University, Nanning, Guangxi, China
| | - Chao-Qian Li
- Department of Respiratory Medicine, Guangxi Medical University, Nanning, Guangxi, China
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