In a review article entitled “Inhaled therapy in cystic fibrosis: agents, devices and regimens” published in the Breathe journal, the authors discuss recent advances in inhaled therapies for the management of cystic fibrosis (CF).
Cystic fibrosis is a genetic disorder which commonly affects the lungs, but can also involve other organs such as the liver, kidneys, intestine, and pancreas. Patients with CF frequently suffer from clogging of the airways due to mucus build-up, inducing inflammation, injury and structural changes of the lungs. As a result, symptoms such as difficulty breathing, coughing, sinus infection, infertility, slow growth, and clubbing of fingers and toes are often associated with the disease. While there is no cure currently available for CF, considerable progress has been made in the past 70 years in the management of the disease. Today, several methods are used for management of the disease, including inhaled and oral medications, airway clearance and optimized nutrition. Among these interventions, the inhaled medication method is considered best because it induces high levels of drugs within the airways with limited systemic effects, offering safe and convenient antibiotic and mucolytic therapy for patients with CF.
In the review, the authors offer a detailed overview of the various therapies available today to manage CF. This includes devices like intelligent nebulizers, drug formulations, muco-active drugs and supporting evidence for inhaled antibiotics utilized in CF due to chronic infection with bacteria pseudomonas aeruginosa. The review aims to inform readers on how inhaled therapies progressed through history. They also include practical advice directed at CF specialists regarding the optimization of inhalation techniques and education of patients suffering with CF. Furthermore; they highlighted the principal factors that play a role in the success of inhaled therapies based on specific devices used for drug delivery, as well as devices that influence adherence.
In conclusion, the authors revealed that CF can be managed by several inhaled therapies. Today, most patients have access to “intelligent nebulizers” that optimize nebulized drug delivery. Also, the emergence of dry-powder inhalers with the potential to boost adherence efficiently are adopted by CF community. Because most therapies demand repeated uses throughout the day, the authors emphasized about the importance of educating patients about taking full prescribed medications in order to achieve maximum efficiency. Although medication adherence is difficult to evaluate accurately, several adherence support programs are on the rise. Overall , the question does not only concern the choice and prescription of the appropriate medication, but also evaluation of the delivery device, CF patients’ lifestyle and adherence requirements in order to maximize the benefit from inhaled therapy.