POTENTIAL DRUG DELIVERY SYSTEMS AND DEVICE COMBINATION FOR THE MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Authors

  • PREETHI S. Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru-570015, Karnataka, India https://orcid.org/0000-0002-6420-7436
  • PRAVEEN HALAGALI Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru-570015, Karnataka, India. Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal-576104, Karnataka, India https://orcid.org/0000-0002-1619-8416
  • SURYA CS Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru-570015, Karnataka, India
  • VIKAS JAIN Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru-570015, Karnataka, India https://orcid.org/0000-0001-5863-3159

DOI:

https://doi.org/10.22159/ijap.2025v17i2.53177

Keywords:

Bronchodilators, GOLD, LABA, LAMA, Triple therapy

Abstract

Chronic Obstructive Pulmonary Disease (COPD) presents with chronic lung inflammation and poorly reversible airflow limitation, necessitating bronchodilators for management. The Global Initiative for COPD recommends combining Long-Acting Beta-Agonists (LABAs) and Long-Acting Antimuscarinic Agents (LAMAs) for most COPD patients. Developing fixed LAMA/lABA combinations is crucial. Adding an Inhaled Corticosteroid (ICS) to this combination may offer additional benefits, including preventing exacerbations. The GOLD report emphasizes diagnosis, prevention, exacerbation management, and addressing comorbidities. It advocates for holistic COPD management, integrating pharmacologic and non-pharmacologic approaches. Novel strategies like mono, dual, and triple therapies are recommended. The review highlights COPD's impact on COVID-19, comorbidities, and relevant patents concerning COPD and bronchodilators. The bronchodilator treatments may improve their efficacy in this critical aspect of COPD. Research shows that dual bronchodilation improves lung function and symptoms more consistently than mono-bronchodilation while potentially lowering the risk of exacerbations and disease deterioration and having a similar safety profile.

References

Quaderi SA, Hurst JR. The unmet global burden of COPD. Glob Health Epidemiol Genom. 2018 Apr 6;3:e4. doi: 10.1017/gheg.2018.1, PMID 29868229.

Rahmad, Narasati S, Nugroho E, Witjaksono D, Lestari DI, Nugroho MB. The role of pulmonary rehabilitation in acute exacerbations of chronic obstructive pulmonary disease. Int J App Pharm. 2020;12(3):39-40. doi: 10.22159/ijap.2020.v12s3.39466.

Khan S, Monika. Circadian rhythms regulated asthma treatment by virtue of pulsatile drug delivery system. Int J Appl Pharm. 2022;14(4):1-8. doi: 10.22159/ijap.2022v14i4.44395.

Christenson SA, Smith BM, Bafadhel M, Putcha N. Chronic obstructive pulmonary disease. Lancet. 2022 Jun 11;399:2227-42. doi: 10.1016/S0140-6736(22)00470-6, PMID 35533707.

Qureshi H, Sharafkhaneh A, Hanania NA. Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. Ther Adv Chronic Dis. 2014;5(5):212-27. doi: 10.1177/2040622314532862, PMID 25177479.

LE Jemtel TH, Padeletti M, Jelic S. Diagnostic and therapeutic challenges in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure. J Am Coll Cardiol. 2007 Jan 16;49(2):171-80. doi: 10.1016/j.jacc.2006.08.046, PMID 17222727.

Barnes PJ. Muscarinic receptor subtypes: implications for therapy. Agents Actions. 1993;43:243-52. doi: 10.1007/978-3-0348-7324-6_21, PMID 8368167.

Haddad EB, Mak JC, Barnes PJ. Characterization of [3H] Ba 679 BR a slowly dissociating muscarinic antagonist in human lung: radioligand binding and autoradiographic mapping. Mol Pharmacol. 1994 May;45(5):899-907. PMID 8190106.

Skolnik NS, Nguyen TS, Shrestha A, Ray R, Corbridge TC, Brunton SA. Current evidence for COPD management with dual long-acting muscarinic antagonist/long-acting β2-agonist bronchodilators. Post Grad Med. 2020 Mar;132(2):198-205. doi: 10.1080/00325481.2019.1702834, PMID 31900019.

Wedzicha JA, Decramer M, Seemungal TA. The role of bronchodilator treatment in the prevention of exacerbations of COPD. Eur Respir J. 2012 Jul 26;40(6):1545-54. doi: 10.1183/09031936.00048912, PMID 22835613.

Beeh KM. The role of bronchodilators in preventing exacerbations of chronic obstructive pulmonary disease. Tuberc Respir Dis (Seoul). 2016;79(4):241-7. doi: 10.4046/trd.2016.79.4.241, PMID 27790275.

Singh D, Donohue JF, Boucot IH, Barnes NC, Compton C, Martinez FJ. Future concepts in bronchodilation for COPD: dual versus monotherapy. Eur Respir Rev. 2021 Jun 1;30(160):210023. doi: 10.1183/16000617.0023-2021, PMID 34415847.

Soler Cataluna JJ, Marzo M, Catalan P, Miralles C, Alcazar B, Miravitlles M. Validation of clinical control in COPD as a new tool for optimizing treatment. Int J COPD. 2018 Nov 14;13:3719-31. doi: 10.2147/COPD.S178149, PMID 30532528.

Vogelmeier CF, Roman Rodriguez M, Singh D, Han ML, Rodriguez Roisin R, Ferguson GT. Goals of COPD treatment: focus on symptoms and exacerbations. Respir Med. 2020 May;166:105938. doi: 10.1016/j.rmed.2020.105938, PMID 32250871.

O Driscoll BR, Babu KS, Chauhan AJ. Management of chronic obstructive pulmonary disease. BMJ. 2003 Apr 12;326:821. doi: 10.1136/bmj.326.7393.821, PMID 12689985.

Safka KA, Andrew McIvor R. Non-pharmacological management of chronic obstructive pulmonary disease. Ulster Med J. 2015 Jan;84(1):13-21. PMID 25964698.

Alagha K, Palot A, Sofalvi T, Pahus L, Gouitaa M, Tummino C. Long-acting muscarinic receptor antagonists for the treatment of chronic airway diseases. Ther Adv Chronic Dis. 2014;5(2):85-98. doi: 10.1177/2040622313518227, PMID 24587893.

KO FW, Chan KP, Hui DS, Goddard JR, Shaw JG, Reid DW. Acute exacerbation of COPD. Respirology. 2016 Oct;21(7):1152-65. doi: 10.1111/resp.12780, PMID 27028990.

Welte T. Optimising treatment for COPD new strategies for combination therapy. Int J Clin Pract. 2009 Aug;63(8):1136-49. doi: 10.1111/j.1742-1241.2009.02139.x, PMID 19624783.

Hunninghake GM, Cho MH, Tesfaigzi Y, Soto Quiros ME, Avila L, Lasky SU J. MMP12 lung function and COPD in high-risk populations. N Engl J Med. 2009;361(27):2599-608. doi: 10.1056/nejmoa0904006, PMID 20018959.

Venkatesan P. GOLD COPD report: 2023 update. Lancet Respir Med. 2023 Jan;11(1):18. doi: 10.1016/S2213-2600(22)00494-5, PMID 36462509.

Lokke A, Nielsen LP, Moberg M, Marsa K, Titlestad IL, Kofod LM. Treatment of stable chronic obstructive pulmonary disease. Ugeskr Laeger. 2019;180:2-6. doi: 10.2147/copd.s3483, PMID 19281074.

Wedzicha JA, Decramer M, Seemungal TA. The role of bronchodilator treatment in the prevention of exacerbations of COPD. Eur Respir J. 2012 Dec;40(6):1545-54. doi: 10.1183/09031936.00048912, PMID 22835613.

Rabe KF, Martinez FJ, Ferguson GT, Wang C, Singh D, Wedzicha JA. Triple inhaled therapy at two glucocorticoid doses in moderate to very severe COPD. N Engl J Med. 2020;383(1):35-48. doi: 10.1056/nejmoa1916046, PMID 32579807.

Lipson DA, Barnhart F, Brealey N, Brooks J, Criner GJ, Day NC. Once daily single inhaler triple versus dual therapy in patients with COPD. N Engl J Med. 2018 May;378(18):1671-80. doi: 10.1056/nejmoa1713901, PMID 29668352.

Rabe KF, Martinez FJ, Ferguson GT, Wang C, Singh D, Wedzicha JA. A phase III study of triple therapy with budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler 320/18/9.6 μg and 160/18/9.6 μg using co-suspension delivery technology in moderate to very severe COPD: the ETHOS study protocol. Respir Med. 2019 Oct;158:59-66. doi: 10.1016/j.rmed.2019.08.010, PMID 31605923.

D Urzo AD, Singh D, Donohue JF, Chapman KR, Wise RA. Aclidinium bromide/formoterol fumarate as a treatment for COPD: an update. Expert Rev Respir Med. 2021 Sep;15(9):1093-106. doi: 10.1080/17476348.2021.1920403, PMID 34137664.

King P. Role of arformoterol in the management of COPD. Int J COPD. 2008 Sep;3(3):385-92. doi: 10.2147/copd.s753, PMID 18990965.

Zheng J, XU JF, Jenkins M, Assam PN, Wang L, Lipworth BJ. Glycopyrrolate/formoterol fumarate metered dose inhaler for maintenance naive patients with chronic obstructive pulmonary disease: a post hoc analysis of the randomized PINNACLE trials. Respir Res. 2020 Mar 12;21(1):69. doi: 10.1186/s12931-020-1332-3, PMID 32164675.

Cazzola M, Bardaro F, Stirpe E. The role of indacaterol for chronic obstructive pulmonary disease (COPD). J Thorac Dis. 2013;5:559-66. doi: 10.3978/j.issn.2072-1439.2013.07.35, PMID 23991316.

Olodaterol another LABA for COPD. Drug Ther Bull. 2015;53:42-5. doi: 10.1136/dtb.2015.4.0319, PMID 25858815.

Tashkin DP, Ohar JA, Koltun A, Allan R, Ward JK. The role of ICS/lABA fixed-dose combinations in the treatment of asthma and COPD: bioequivalence of a generic fluticasone propionate salmeterol device. Pulm Med. 2021 Mar 17;2021:8881895. doi: 10.1155/2021/8881895, PMID 33815843.

Anzueto A, Miravitlles M. Tiotropium in chronic obstructive pulmonary disease a review of clinical development. Respir Res. 2020 Jul 29;21(1):199. doi: 10.1186/s12931-020-01407-y, PMID 32727455.

Umeclidinium. Another LAMA for COPD. Drug Ther Bull. 2015;53(7):81-4. doi: 10.1136/dtb.2015.7.0340, PMID 26159701.

Yang IA, Brown JL, George J, Jenkins S, MC Donald CF, MC Donald VM. COPD-X australian and new zealand guidelines for the diagnosis and management of chronic obstructive pulmonary disease: 2017 update. Med J Aust. 2017 Nov 20;207(10):436-42. doi: 10.5694/mja17.00686, PMID 29129177.

Singh D. Pharmacological treatment of stable chronic obstructive pulmonary disease. Respirology. 2021 Jul;26(7):643-51. doi: 10.1111/resp.14046, PMID 33829619.

Van Der Molen T, Cazzola M. Beyond lung function in COPD management: effectiveness of LABA/lAMA combination therapy on patient-centred outcomes. Prim Care Respir J. 2012;21(1):101-8. doi: 10.4104/pcrj.2011.00102, PMID 22222945.

Pennington E, Bell S, Hill JE. Should video laryngoscopy or direct laryngoscopy be used for adults undergoing endotracheal intubation in the pre-hospital setting? a critical appraisal of a systematic review. J Paramed Pract. 2023;15(6):255-9. doi: 10.1002/14651858, PMID 38812899.

Janson C. Treatment with inhaled corticosteroids in chronic obstructive pulmonary disease. J Thorac Dis. 2020;12(4):1561-9. doi: 10.21037/jtd.2020.02.51, PMID 32395293.

Tashkin D, Celli B, Senn S, Burkhart D, Kesten S, Menjoge S. A 4 y trial of tiotropium in chronic obstructive pulmonary disease (UPLIFT trial). Rev Port Pneumol. 2009;15(1):137-40. doi: 10.1016/S0873-2159(15)30121-5, PMID 25965528.

Tashkin DP, Ohar JA, Koltun A, Allan R, Ward JK. The role of ICS/lABA fixed-dose combinations in the treatment of asthma and COPD: bioequivalence of a generic fluticasone propionate salmeterol device. Pulm Med. 2021 Mar 17;2021:8881895. doi: 10.1155/2021/8881895, PMID 33815843.

Busse WW, Shah SR, Somerville L, Parasuraman B, Martin P, Goldman M. Comparison of adjustable and fixed-dose budesonide/formoterol pressurized metered dose inhaler and fixed-dose fluticasone propionate/salmeterol dry powder inhaler in asthma patients. J Allergy Clin Immunol. 2008 Jun;121(6):1407-14. doi: 10.1016/j.jaci.2008.03.019, PMID 18455221.

Berger WE. Mometasone furoate/formoterol in the treatment of persistent asthma. Expert Rev Respir Med. 2011 Dec;5(6):739-46. doi: 10.1586/ers.11.71, PMID 22082160.

Syed YY. Fluticasone furoate/vilanterol: a review of its use in patients with asthma. Drugs. 2015 Mar;75(4):407-18. doi: 10.1007/s40265-015-0354-5, PMID 25648266.

Mc Keage K, Keam SJ. Salmeterol fluticasone propionate: a review of its use in asthma. Drugs. 2009;69(13):1799-828. doi: 10.2165/11202210-000000000-00000, PMID 19719334.

Van Noord JA, Aumann JL, Janssens E, Smeets JJ, Zaagsma J, Mueller A. Combining tiotropium and salmeterol in COPD: effects on airflow obstruction and symptoms. Respir Med. 2010 Jul;104(7):995-1004. doi: 10.1016/j.rmed.2010.02.017, PMID 20303247.

Vogelmeier C, Kardos P, Harari S, Gans SJ, Stenglein S, Thirlwell J. Formoterol mono and combination therapy with tiotropium in patients with COPD: A 6-month study. Respir Med. 2008;102:1511-20. doi: 10.1016/j.rmed.2008.07.020, PMID 18804362.

National Institute for Health and Care Excellence. Chronic obstructive pulmonary disease: beclometasone formoterol and glycopyrronium (Trimbow). Nice Advice; 2018. p. 1-78.

Richeldi L, Piraino A, Macagno F, Micarelli G, Ingrassia E. The impact of fixed triple therapy with beclometasone/formoterol/glycopyrronium on health status and adherence in chronic obstructive pulmonary disease (COPD) in an Italian context of real life: the tritrial study protocol. Int J COPD. 2021 Jan 27;16:159-66. doi: 10.2147/COPD.S286559, PMID 33536751.

Papi A, Vestbo J, Fabbri L, Corradi M, Prunier H, Cohuet G. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (Tribute): a double-blind parallel group randomized controlled trial. Lancet. 2018 Mar 17;391(10125):1076-84. doi: 10.1016/S0140-6736(18)30206-X, PMID 29429593.

Mahler DA, Buhl R, Lawrence D, MC Bryan D. Efficacy and safety of indacaterol and tiotropium in COPD patients according to dyspnoea severity. Pulm Pharmacol Ther. 2013 Jun;26(3):348-55. doi: 10.1016/j.pupt.2013.02.006, PMID 23434446.

Mahler DA, D Urzo A, Bateman ED, Ozkan SA, White T, Peckitt C. Concurrent use of indacaterol plus tiotropium in patients with COPD provides superior bronchodilation compared with tiotropium alone: a randomised double-blind comparison. Thorax. 2012;67(9):781-8. doi: 10.1136/thoraxjnl-2011-201140, PMID 22544891.

D Urzo A, Rennard S, Kerwin E, Donohue JF, Lei A, Molins E. A randomised double-blind placebo-controlled long-term extension study of the efficacy safety and tolerability of fixed dose combinations of aclidinium/formoterol or monotherapy in the treatment of chronic obstructive pulmonary disease. Respir Med. 2017 Apr;125:39-48. doi: 10.1016/j.rmed.2017.02.008, PMID 28340861.

Ferguson GT, Taylor AF, Thach C, Wang Q, Schubert Tennigkeit AA, Patalano F. Long-term maintenance bronchodilation with indacaterol/glycopyrrolate versus indacaterol in moderate to severe COPD patients: the FLIGHT 3 study. Chronic Obstr Pulm Dis. 2016;3(4):716-28. doi: 10.15326/jcopdf.3.4.2016.0131, PMID 28848898.

O Donnell DE, Casaburi R, Frith P, Kirsten A, DE Sousa D, Hamilton A. Effects of combined tiotropium/olodaterol on inspiratory capacity and exercise endurance in COPD. Eur Respir J. 2017 Apr 19;49(4):1601348. doi: 10.1183/13993003.01348-2016, PMID 28424359.

Maltais F, Singh S, Donald AC, Crater G, Church A, Goh AH. Effects of a combination of umeclidinium/vilanterol on exercise endurance in patients with chronic obstructive pulmonary disease: two randomized double-blind clinical trials. Ther Adv Respir Dis. 2014 Dec;8(6):169-81. doi: 10.1177/1753465814559209, PMID 25452426.

Martinez FJ, Rabe KF, Ferguson GT, Fabbri LM, Rennard S, Feldman GJ. Efficacy and safety of glycopyrrolate/formoterol metered dose inhaler formulated using co-suspension delivery technology in patients with COPD. Chest. 2017 Feb;151(2):340-57. doi: 10.1016/j.chest.2016.11.028, PMID 27916620.

Jung KS, Park HY, Park SY, Kim SK, Kim YK, Shim JJ. Comparison of tiotropium plus fluticasone propionate/salmeterol with tiotropium in COPD: a randomized controlled study. Respir Med. 2012 Mar;106(3):382-9. doi: 10.1016/j.rmed.2011.09.004, PMID 21975275.

Chatterjee A, Shah M, D Souza AO, Bechtel B, Crater G, Dalal AA. Observational study on the impact of initiating tiotropium alone versus tiotropium with fluticasone propionate/salmeterol combination therapy on outcomes and costs in chronic obstructive pulmonary disease. Respir Res. 2012 Feb 17;13(1):15. doi: 10.1186/1465-9921-13-15, PMID 22340019.

Singh D, Brooks J, Hagan G, Cahn A, O Connor BJ. Superiority of triple therapy with salmeterol/fluticasone propionate and tiotropium bromide versus individual components in moderate to severe COPD. Thorax. 2008 Jul;63(7):592-8. doi: 10.1136/thx.2007.087213, PMID 18245142.

Maltais F, Hamilton A, Voß F, Maleki Yazdi MR. Dose determination for a fixed dose drug combination: a phase II randomized controlled trial for tiotropium/olodaterol versus tiotropium in patients with COPD. Adv Ther. 2019 Apr;36(4):962-8. doi: 10.1007/s12325-019-00911-y, PMID 30843141.

Bogart M, Stanford RH, Laliberte F, Germain G, WU JW, Duh MS. Medication adherence and persistence in chronic obstructive pulmonary disease patients receiving triple therapy in a USA commercially insured population. Int J COPD. 2019 Feb 19;14:343-52. doi: 10.2147/COPD.S184653, PMID 30863037.

Gaduzo S, MC Govern V, Roberts J, Scullion JE, Singh D. When to use single inhaler triple therapy in COPD: a practical approach for primary care health care professionals. Int J COPD. 2019 Feb13;14:391-401. doi: 10.2147/COPD.S173901, PMID 30863039.

Pascoe S, Barnes N, Brusselle G, Compton C, Criner GJ, Dransfield MT. Blood eosinophils and treatment response with triple and dual combination therapy in chronic obstructive pulmonary disease: analysis of the impact trial. Lancet Respir Med. 2019 Sep;7(9):745-56. doi: 10.1016/S2213-2600(19)30190-0, PMID 31281061.

Pascoe S, Locantore N, Dransfield MT, Barnes NC, Pavord ID. Blood eosinophil counts exacerbations and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials. Lancet Respir Med. 2015 Jun;3(6):435-42. doi: 10.1016/S2213-2600(15)00106-X, PMID 25878028.

Vanfleteren LE, Ullman A, Nordenson A, Andersson A, Andelid K, Fabbri LM. Triple therapy (ICS/lABA/lAMA) in COPD: thinking out of the box. ERJ Open Res. 2019;5(1):00185-2018. doi: 10.1183/23120541.00185-2018, PMID 30775372.

Ritondo BL, Puxeddu E, Calzetta L, Cazzola M, Rogliani P. Efficacy and safety of triple combination therapy for treating chronic obstructive pulmonary disease: an expert review. Expert Opin Pharmacother. 2021;22(5):611-20. doi: 10.1080/14656566.2020.1845314, PMID 33131340.

COPD global initiative. Global Initiative for Chronic Obstructive Lung Disease; 2020.

Singh D, Fabbri LM, Corradi M, Georges G, Guasconi A, Vezzoli S. Extrafine triple therapy in patients with symptomatic COPD and history of one moderate exacerbation. Eur Respir J. 2019 May 18;53(5):1900235. doi: 10.1183/13993003.00235-2019, PMID 30792343.

Vestbo J, Papi A, Corradi M, Blazhko V, Montagna I, Francisco C. Single inhaler extra fine triple therapy versus long-acting muscarinic antagonist therapy for chronic obstructive pulmonary disease (trinity): a double-blind, parallel-group randomised controlled trial. Lancet. 2017 May 13;389(10082):1919-29. doi: 10.1016/S0140-6736(17)30188-5, PMID 28385353.

Papi A, Vestbo J, Fabbri L, Corradi M, Prunier H, Cohuet G. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (Tribute): a double blind, parallel-group randomised controlled trial. Lancet. 2018 Mar 17;391(10125):1076-84. doi: 10.1016/S0140-6736(18)30206-X, PMID 29429593.

Gross N. The COPD pipeline XXX. Chronic Obstr Pulm Dis. 2015;3(1):498-502. doi: 10.15326/jcopdf.3.1.2015.0181, PMID 28848873.

Lipson DA, Barnacle H, Birk R, Brealey N, Locantore N, Lomas DA. Fulfil trial: once daily triple therapy for patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017 Aug 15;196(4):438-46. doi: 10.1164/rccm.201703-0449OC, PMID 28375647.

Ferguson GT, Rabe KF, Martinez FJ, Fabbri LM, Wang C, Ichinose M. Triple therapy with budesonide/glycopyrrolate/formoterol fumarate with co-suspension delivery technology versus dual therapies in chronic obstructive pulmonary disease (KRONOS): a double-blind parallel-group multicentre phase 3 randomised controlled trial. Lancet Respir Med. 2018 Oct;6(10):747-58. doi: 10.1016/S2213-2600(18)30327-8, PMID 30232048.

Halpin DM, Criner GJ, Papi A, Singh D, Anzueto A, Martinez FJ. Global initiative for the diagnosis, management and prevention of chronic obstructive lung disease. Am J Respir Crit Care Med. 2021;203(1):24-36. doi: 10.1164/rccm.202009-3533SO, PMID 33146552.

Vestbo J, Papi A, Corradi M, Blazhko V, Montagna I, Francisco C. Single inhaler extrafine triple therapy versus long acting muscarinic antagonist therapy for chronic obstructive pulmonary disease (trinity): a double blind parallel group randomised controlled trial. Lancet. 2017 May 13;389(10082):1919-29. doi: 10.1016/S0140-6736(17)30188-5, PMID 28385353.

Tsiligianni I, Goodridge D, Marciniuk D, Hull S, Bourbeau J. Four patients with a history of acute exacerbations of COPD: implementing the chest/canadian thoracic society guidelines for preventing exacerbations. NPJ Prim Care Respir Med. 2015 May 7;25:15023. doi: 10.1038/npjpcrm.2015.23, PMID 25950092.

Ferguson GT, Rabe KF, Martinez FJ, Fabbri LM, Wang C, Ichinose M. Triple therapy with budesonide/glycopyrrolate/formoterol fumarate with co-suspension delivery technology versus dual therapies in chronic obstructive pulmonary disease (Kronos): a double blind parallel group multicentre phase 3 randomised controlled trial. Lancet Respir Med. 2018 Oct;6(10):747-58. doi: 10.1016/S2213-2600(18)30327-8, PMID 30232048.

Rabe KF, Martinez FJ, Ferguson GT, Wang C, Singh D, Wedzicha JA. Triple inhaled therapy at two glucocorticoid doses in moderate to very severe COPD. N Engl J Med. 2020;383:35-48. doi: 10.1056/nejmoa1916046, PMID 32579807.

YU AP, Guerin A, Ponce DE Leon D, Ramakrishnan K, WU EQ, Mocarski M. Therapy persistence and adherence in patients with chronic obstructive pulmonary disease: multiple versus single long-acting maintenance inhalers. J Med Econ. 2011;14(4):486-96. doi: 10.3111/13696998.2011.594123, PMID 21679019.

Gaduzo S, MC Govern V, Roberts J, Scullion JE, Singh D. When to use single inhaler triple therapy in COPD: a practical approach for primary care health care professionals. Int J COPD. 2019 Feb 13;14:391-401. doi: 10.2147/COPD.S173901, PMID 30863039.

Fabbri LM, Roversi S, Beghe B. Triple therapy for symptomatic patients with COPD. Lancet. 2017 May 13;389(10082):1864-5. doi: 10.1016/S0140-6736(17)30567-6, PMID 28385354.

Hurst JR, Vestbo J, Anzueto A, Locantore N, Mullerova H, Tal Singer R. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010;363:1128-38. doi: 10.1056/nejmoa0909883, PMID 20843247.

Han ML, Quibrera PM, Carretta EE, Barr RG, Bleecker ER, Bowler RP. Frequency of exacerbations in patients with chronic obstructive pulmonary disease: an analysis of the spiromics cohort. Lancet Respir Med. 2017 Aug;5(8):619-26. doi: 10.1016/S2213-2600(17)30207-2, PMID 28668356.

Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock SJ, Wines RC. Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. Ann Intern Med. 2012 Dec 4;157(11):785-95. doi: 10.7326/0003-4819-157-11-201212040-00538, PMID 22964778.

Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, Fitz Geralde M. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008 Jan;31(1):143-78. doi: 10.1183/09031936.00138707, PMID 18166595.

Bender BG. Nonadherence to asthma treatment: getting unstuck. J Allergy Clin Immunol Pract. 2016 Sep-Oct;4(5):849-51. doi: 10.1016/j.jaip.2016.07.007, PMID 27587318.

Mehta PP, Dhapte Pawar VS. Repurposing drug molecules for new pulmonary therapeutic interventions. Drug Deliv Transl Res. 2021 Oct;11(5):1829-48. doi: 10.1007/s13346-020-00874-6, PMID 33188495.

Mehta PP, Dhapte Pawar VS. Novel and evolving therapies for COVID-19 related pulmonary complications. Am J Med Sci. 2021 May;361(5):557-66. doi: 10.1016/j.amjms.2021.02.019, PMID 33640363.

Leung JM, Niikura M, Yang CW, Sin DD. COVID-19 and COPD. Eur Respir J. 2020 Aug 13;56(2):2002108. doi: 10.1183/13993003.02108-2020, PMID 32269089.

https://www.healthline.com/health/copd/drugs.

Cheyne L, Irvin Sellers MJ, White J. Tiotropium versus ipratropium bromide for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015 Sep 22;2015(9):CD009592. doi: 10.1002/14651858, PMID 26391969.

Hanania NA, Donohue JF, Nelson H, Sciarappa K, Goodwin E, Baumgartner RA. The safety and efficacy of arformoterol and formoterol in COPD. COPD J Chronic Obstruct Pulm Dis. 2010 Feb;7(1):17-31. doi: 10.3109/15412550903499498, PMID 20214460.

Keating GM, MC Cormack PL. Salmeterol/fluticasone propionate: a review of its use in the treatment of chronic obstructive pulmonary disease. Drugs. 2007;67(16):2383-405. doi: 10.2165/00003495-200767160-00006, PMID 17983257.

Heo YA. Budesonide/Glycopyrronium/Formoterol: a review in COPD. Drugs. 2021 Aug;81(12):1411-22. doi: 10.1007/s40265-021-01562-6, PMID 34342835.

Cazzola M, Rogliani P, Stolz D, Matera MG. Pharmacological treatment and current controversies in COPD. F1000Res. 2019;8:F1000 Faculty Rev-1533. doi: 10.12688/f1000research.19811.1, PMID 31508197.

Lavorini F, Fontana GA, Usmani OS. New inhaler devices the good the bad and the ugly. Respiration. 2014;88(1):3-15. doi: 10.1159/000363390, PMID 24902629.

Ibrahim M, Verma R, Garcia Contreras L. Inhalation drug delivery devices: technology update. Med Devices Evid Res. 2015 Feb 12;8:131-9. doi: 10.2147/MDER.S48888, PMID 25709510.

Labiris NR, Dolovich MB. Pulmonary drug delivery part II: the role of inhalant delivery devices and drug formulations in therapeutic effectiveness of aerosolized medications. Br J Clin Pharmacol. 2003 Dec;56(6):600-12. doi: 10.1046/j.1365-2125.2003.01893, PMID 14616419.

Park H, Otte A, Park K. Evolution of drug delivery systems: from 1950 to 2020 and beyond. J Control Release. 2022 Feb;342:53-65. doi: 10.1016/j.jconrel.2021.12.030, PMID 34971694.

Adepu S, Ramakrishna S. Controlled drug delivery systems: current status and future directions. Molecules. 2021;26(19):5905. doi: 10.3390/molecules26195905, PMID 34641447.

Hardinge M, Rutter H, Velardo C, Shah SA, Williams V, Tarassenko L. Using a mobile health application to support self management in chronic obstructive pulmonary disease: a six month cohort study eHealth/telehealth/mobile health systems AC-63541e8b0e2a0d7170bcd513bb89d0cf. BMC Med Inform Decis Mak. 2015;15. doi: 10.1186/s12911-015-0171-5, PMID 26084626.

https://clinicaltrials.gov/search?intr=bronchodilators%20in%20the%20treatment%20of%20COPD. [Last accessed on 06 Feb 2025].

Miravitlles M, Acharya S, Aggarwal B, Fernandes FL, Jardim JR, Juthong S. Clinical concepts for triple therapy use in patients with COPD: a delphi consensus. Int J COPD. 2023;18:1853-66. doi: 10.2147/COPD.S424128, PMID 37662490.

Kato M, Tomii K, Hashimoto K, Nezu Y, Ishii T, Jones CE. The Impact study single inhaler triple therapy (FF/UMEC/VI) versus FF/VI and UMEC/VI in patients with COPD: efficacy and safety in a Japanese population. Int J COPD. 2019;14:2849-61. doi: 10.2147/COPD.S226601, PMID 31839705.

Tan DJ, Van Geffen WH, Walters EH. Impact of triple therapy vs dual bronchodilator therapy on mortality rates in COPD. Chest. 2024;165:e158-9. doi: 10.1016/j. chest.2023.12.033, PMID 38724158.

Esteban C, Arostegui I, Aramburu A, Moraza J, Aburto M, Aizpiri S. Changes in health related quality of life as a marker in the prognosis in COPD patients. ERJ Open Res. 2022 Jan 10;8(1):00181-2021. doi: 10.1183/23120541.00181-2021,

Published

07-03-2025

How to Cite

S., P., HALAGALI, P., CS, S., & JAIN, V. (2025). POTENTIAL DRUG DELIVERY SYSTEMS AND DEVICE COMBINATION FOR THE MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. International Journal of Applied Pharmaceutics, 17(2), 1–11. https://doi.org/10.22159/ijap.2025v17i2.53177

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Review Article(s)

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