Meds question—research information

Hello…..can anyone share experiences or information about the research material below.  It talks about new treatments to protect the small airways.  The main idea is new medicines that have smaller particle sizes, and thus can get further into the small airways that traditional puffers and inhalants can (flovent, alvescio, etc).  It sounds promising, and the indication from the material below is that when utilized, it really improves the flow of air into the small airways and protects them from closing and being damaged.

Thank you so kindly for your time and responses.



Excerpts from Article: Treatments Targeting the Small Airways in Chronic Obstructive Pulmonary DiseasePharmacologic therapies for COPD include the use of inhaled corticosteroids (ICS), long-acting beta-agonists (LABAs), and long-acting muscarinic antagonists. These therapies have been shown to reduce symptoms, improve health-related quality of life, and prevent exacerbations as well as hospitalizations. Although ICS is a highly effective therapy in almost all patients with asthma, the role of ICS in patients with stable COPD remains controversial.[2,26] This might be the result of a difference in the type of inflammation in asthma versus COPD, the effect of cigarette smoke, or the loss of lung tissue in COPD. Alternatively, the difference in the effect of ICS could be explained by drug delivery. The traditional ICS is a large particle ICS which does not easily reach the peripheral airways, the site of a majority of the inflammation. Beclomethasone dipropionate (BDP) has been reformulated using hydrofluoroalkane-134a (HFA) as a propellant. This combination forms a solution that on evaporatation forms an extra-fine aerosol of small droplets. Although there have been a number of studies evaluating the efficacy of extra-fine drug delivery in asthma, there are limited studies in patients with COPD.  Three studies have examined the use of HFA-BDP in COPD in relation to either placebo or large particle ICS (fluticasone or budesonide). Van Beurden et al.[27] showed that ICS did reduce the concentration of exhaled H2O2 (surrogate for levels of oxidative stress), but there was no difference depending on the delivery of the ICS (small versus large particle). This is either because of the carry-over effect during the washout period or indicates that homogenous deposition of drug is achieved regardless of the size of the particles. John et al.[28] observed a 13% reduction in RV/TLC and a 6.4-point improvement in St. Georges Respiratory Questionnaire (SGRQ) with HFA-BDP compared with placebo, but no effect on FEV1 or cytokine levels.

Tatsis et al.[29] showed that after 8 weeks of therapy, the individuals switched to HFA-BDP demonstrated a greater improvement in spirometric values and respiratory symptoms, and a decrease in Β2-agonist use compared with those who remained on large particle ICS. The investigators also showed that low-dose HFA-BDP was more effective than medium-dose use of a traditional inhalant.

These studies support the improved efficacy of extra-fine aerosol respiratory treatments for COPD that have a deeper penetration into the lungs, and therefore the small airways



Comments 1

  • Kathy P

    Hi Natasha – do you have a link to this article? Since this is copyright material, we need to trim it down to a snippet and include a link.  Thanks!