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The UK National Health Service (NHS) has launched the PRECISION Asthma Mobile Clinic provided by AstraZeneca, which will partner with local NHS respiratory services to accelerate delivery of asthma care.

A respiratory nurse realized that understanding asthma could help children gain better disease control, and reduce emergency department attendance and length of hospital admissions. She wanted to reach children quickly and cover a geographical area efficiently. So she asked, “Could we have an asthma bus?”
The Pulmonary Fibrosis Foundation maintains a database of molecules and clinical programs in development for IPF. As of June 2021, while it may not be comprehensive, it listed 33 programs, yet shows only five via the inhaled route. Why then, given the availability of the technology and manufacturing knowledge, and the inherent medical advantages of inhaled drugs, are manufacturers pursuing conventional oral and IV formulations?
The article provides a rationale for and examples demonstrating the applicability of NGI gravimetric insert cups for measurement of APSDs of homogeneous liquid suspension and dry particle aerosols. This method can be an alternative or complement to drug-specific NGI or non impaction-based methods to avoid drug-specific assay variability or satisfy regulatory expectations for impaction-based APSD approaches. It may also help address aerosol characterization needs in phase-appropriate product development strategies.
For millions in the US newly experiencing food insecurity due to the COVID-19 pandemic, those with food allergies are facing “a particular crisis” in that most charitable and government food programs offer limited options that are safely edible. The Food Equality Initiative and Porchlight Community Services are two organizations that support clients with food allergies.

Multiple studies have been conducted to determine whether food insecurity is associated with asthma and, if so, to evaluate the extent of such a relationship. However, results are conflicting.
In this article, the fundamental thermophysical properties that control the complex internal flow and aerosol formation process in a pMDI will be examined, from the perspective of their measurement, representation and prediction. Activity coefficient models that enable simultaneous description and prediction of important formulation thermophysical properties will also be presented. The performance of these models is demonstrated using existing data for HFA134a/ethanol mixtures, to show their potential application alongside experimental property data collection involving future propellants.
Some commercially available liquid nasal spray formulations include excipients that can act as penetration enhancers or mucoadhesives. They may thereby provide the benefit of increasing contact/residence time in the nasal cavity or increasing absorption of drug molecules by enhancing permeability through nasal mucosal membranes. This review may assist readers in considering the utility of various penetration enhancers and mucoadhesives for use in research and development.
Surface composition and interfacial properties of dry powder particles play a significant role in the processing, structure and functionality of orally inhaled dry powders. Therefore, advanced surface characterization techniques, such as AFM, XPS and ToF-SIMS, are critical to better understanding powder behavior in the early stages of DPI formulation, which may help avoid stability issues later in development.
The third in a series of articles from the IPAC-RS Cascade Impaction Working Group concerning the limitations of metrics commonly used in the assessment of aerodynamic particle size distributions (APSDs) of orally inhaled products (OIPs). The current article takes a broader view to discuss why we make quality control measurements such as inhaler APSD.
The most severe thunderstorm asthma (TA) event reported caused approximately 14,000 people in Melbourne, Australia to seek emergency care for respiratory symptoms and contributed to 10 deaths. The Victorian Grass Pollen Emission Module is being used to study mechanisms for these rare events. Surprisingly, high humidity was not a factor but strong winds, lightning strikes and static electricity due to low humidity may be causes.
The Kigali Amendment to the Montreal Protocol aims to phase-down global HFA consumption. While volumes of hydrofluoroalkane (HFA) gases used by the inhalation and respiratory healthcare industry are relatively small, it is likely we will see supply shortages in the future as other industries completely phase out their use. This article discusses ways the inhalation industry can prepare for and be ready to adopt new propellants to guarantee continued, reliable manufacture and supply of vital medicines for patients.
A useful explanation is provided in a table that compares the Kigali Amendment to the Montreal Protocol and the Paris Agreement, with respect to substances, goals, criteria for entering into force, differences between developing/developed countries, approach and compliance. Reprinted with kind permission of the Montreal Protocol Division at the United Nations Industrial Development Organization (UNIDO).
This article presents case studies and highlights ways key physical properties of drug substance particles might be adjusted and measured to meet a quality target product profile (QTPP). Morphic form, particle shape and surface characterization were studied and a variety of analytical techniques were used. Characterization results for fluticasone propionate, fluticasone furoate, vilanterol trifenatate and/or salmeterol xinafoate powders, micronized by jet milling and/or wet polishing, and various process parameters for the techniques, are discussed.
FARE (Food Allergy Research & Education) recently launch a global research competition, with $3 million in prize money, for development of a new diagnostic test to identify allergies in patients. They also announced passage of a new law in the United States requiring labeling of sesame in packaged foods and additional government focus on food allergy research.
This article discusses important misconceptions that from-time-to-time have appeared concerning the analysis of particle size data. It primarily focuses on multi-stage cascade impaction, which is the primary technique for OIP APSD measurement. However, attention is also paid to the analysis of size distribution data from time-of-flight analyzers and laser diffractometer instruments that are also encountered in the evaluation of inhaler performance, particularly the latter for the assessment of nasal products.
The guidelines for prescribing, testing and management of asthma have been updated by the National Asthma Education and Prevention Program (NAEPP) Coordinating Committee, coordinated by the National Heart, Lung, and Blood Institute (NHLBI) of the US National Institutes of Health (NIH). The update is not a complete revision of the prior guidelines but focuses on six topics including inhaled corticosteroids (ICS) and long-acting muscarinic antagonists (LAMA).
Unanswered questions relating to pre-aerosolized formulations include (1) What does the blend formulation truly look like? (2) How do different parts of the blend interact with each other? (3) How do we quantify the microstructure? (4) How does the microstructure change due to manufacturing processes or storage? This article explores how X-ray microscopy can offer new insights into the microstructure of inhalable formulations for dry powder inhalers. The findings are part of the INFORM2020 collaboration.
A study presented at the virtual 2020 ERS Congress demonstrated “an automatic, electronic alert on general practitioners’ computer screens can help prevent excessive prescribing of short-acting beta2-agonist (SABA) inhalers.” The most important finding was the small but potentially clinically significant reduction in SABA prescribing in the 12 months after the alert. Combined with other results, this suggests the alert prompts a review of patients who may have poor asthma control.
“Repurposing” of oral or parenteral products to the inhaled form is a promising way to develop products for treatment of many serious diseases, particularly where the lung is the natural site of action or optimal delivery location. Factors such as target product profile, product quality, pharmacology and clinical strategy should be taken into account to help provide a repurposed inhaled medication that may be a valuable option for patients.
Pulmonary arterial hypertension is a rare, progressive disorder characterized by elevated blood pressure in and blockage of pulmonary arterioles, due to defective endothelial function and abnormal proliferation of the pulmonary artery smooth muscle cells and fibroblasts. Repurposing drugs for inhaled delivery can offer new treatment options and clinical trials have been completed or are underway. Further research is warranted to establish these repurposed, inhaled drugs for use alone or in combination with existing therapies.
Nasal drug delivery has been a mainstay for local indications since the late 1900s. Delivery systems have evolved from less-precise dosing systems to sophisticated devices designs able to protect formulations and achieve reliable dosing. Further advances are anticipated, including connected applications. In addition, intranasal administration has become a trusted route for rescue medications. In the future, unmet needs may also be addressed in niche patient populations.
The authors conclude a three-part series describing a new approach to quality requirements for cascade impactors (CIs). Their thesis is that the inhaler testing community, both from the manufacturer and regulator perspectives, should insist that the CI quality specifications be both necessary and sufficient  for the testing of batches of drug product for release of that product to the public. Ideally, they hope such methodology would guide developers of new OIPs in making proposals for impactor quality specifications to regulators. In turn, regulators need to assure that specifications are both necessary and sufficient for batch release testing in quality control.
The report demonstrates that “racial gaps in asthma outcomes have not changed over the past 15 years. The burden of asthma in the US continues to fall disproportionately on Black, Hispanic and American Indian/Alaska Native people. The reports also identifies 69 “specific strategies and tactics for prioritizing policies and programs to improve asthma health for Americans most at risk while dismantling systems that fuel harmful disparities.”
A drive to reduce carbon footprints provides motivation to adopt alternative propellants for pressurized metered dose inhalers (pMDIs). Yet the interests of the patient must be foremost in any approach to change. A number of materials have been considered as potential propellants for pMDIs. HFA-152a is under investigation and, to date, has shown an attractive combination of environmental and formulation performance properties.
While oral or injected dosing of animals is straightforward, inhaled administration of drugs presents technical and logistical challenges. This article outlines considerations and industry practices for performing non-clinical studies in support of inhaled drug development. Topics include selection of test species, generation of the test atmosphere and its presentation to animals, aerosol characterization, dosimetry and pulmonary deposition of inhaled test materials.