Chiesi is working to develop and manufacture medicinal products for people with respiratory diseases, including asthma and COPD (chronic obstructive pulmonary disease), and to improve their quality of life. Both asthma and COPD are characterized by reduced respiratory flow, even though the underlying causes differ from each other.
According to WHO’s latest estimates, 235 million people worldwide suffer from asthma. 64 million people have COPD (WHO, 2004), and it is anticipated to become the third leading cause of death by 2030. If no actions are taken to reduce the most common factor, cigarette smoking, the number of estimated COPD-related deaths is expected to increase by 30% over the next 10 years.1
In the search for continued improvement in the health of patients, Chiesi Farmaceutici researches and develops new therapeutic solutions based on the innovative formulation technology Modulite®, which allows the creation of spray solutions (pMDI, pressurised Metered Dose Inhaler) for inhalation able to deliver extra-fine particles. Chiesi Farmaceutici has patented and introduced into the market a dry powder-based medical device for inhalation (DPI, dry powder inhaler), which is also able to deliver extra-fine particles.
ASTHMA AT A GLANCE
Asthma is a chronic inflammatory disease characterised by recurrent respiratory symptoms such as breathlessness, cough and wheezing as well as chest tightness. In normal conditions, the air is free to move within our lungs through a complex conductive system also called airways. In specific conditions and when asthmatic patient conditions are uncontrolled, the airways are more prone to inflammation, triggering an asthma attack. As a consequence, several changes occur including bronchoconstriction, thickening of the internal mucosa and plugging of small airways, which in turn make breathing more difficult. However, these clinical manifestations are basically reversible, although varying greatly over time or between patients. Generally, the asthmatic status tends to deteriorate during the night or the early hours of the morning. Although it is not possible to recover from asthma, optimal disease control is achievable, ensuring patients maintain an adequate quality of life. But what causes asthma? An asthmatic attack is triggered when a susceptible person comes into contact with irritants. In particular, predisposing factors are genetic (which explains greater incidence in those related to sufferers), the presence of allergies, female gender, obesity and ethnic origin. At the same time, factors such as allergens, professional pollutants, tobacco smoke, environmental pollution and airway infections may trigger an asthmatic attack if inhaled in significant quantities. Asthma occurs more frequently in children and adolescents, although in recent years diagnosis in adults and the elderly are becoming more and more frequent.2
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
COPD is a lung disease characterized by persistent bronchial constriction associated in the airways with an increase in chronic inflammatory response to noxious particles or gases. The classic symptoms of COPD are shortness of breath, chronic cough and chronic phlegm production. Sometimes these symptoms may worsen acutely and trigger an exacerbation. There is a dual-mechanism underlying the bronchial obstruction in COPD patients: on the one hand, the inflammation of the bronchioles causes the mucous membranes of the bronchial tubes to swell, which results in increased resistance to airflow. On the other hand, the progressive breaking down of lung tissue (emphysema) causes a decreased elasticity of the lungs. It is important to emphasise that both mechanisms may coexist and cause a reduced airflow throughout the lungs.
What risk factors are associated with COPD? First and foremost, there are genetic risk factors that may predispose some people to develop the disease. The most important risk factors are cigarette smoke, exposure to pollutants in the home (from cooking or combustion of biofuel) or environmental pollution. Other factors include age, gender, socio-economic status, respiratory infections, asthma and chronic bronchitis. COPD patients are generally more likely to develop cardiovascular disease, osteoporosis, diabetes, lung cancer and bronchiectasis, which in turn increases the risk of hospital admission or the risk of dying. Unlike asthma, COPD is a disease that has its onset late in life and is more common among adults because it is associated with a slow and progressive exposure to the risk factors.3