Is there room for further innovation in inhaled therapy for airways disease?

Inhaled medication is the cornerstone in the treatment of patients across a spectrum of respiratory diseases including asthma and chronic obstructive pulmonary disease. The benefits of inhaled therapy have long been recognised but the most important innovations have occurred over the past 60 years, beginning with the invention of the pressurised metered dose inhaler. However, despite over 230 different device and drug combinations currently being available, disease control is far from perfect. Here we look at how innovation in inhaler design may improve treatments for respiratory diseases and how new formulations may lead to treatments for diseases beyond the lungs. We look at the three main areas where innovation in inhaled therapy is most likely to occur: 1) device engineering and design; 2) chemistry and formulations; and 3) digital technology associated with inhalers. Inhaler design has improved significantly but considerable challenges still remain in order to continually innovate and improve targeted drug delivery to the lungs. Healthcare professionals want see innovations that motivate their patients to achieve their goal of improving their health, through better adherence to treatment. Patients want devices that are easy to use and to see that their efforts are rewarded by improvements in their condition. KEY POINTS: The dictionary definition of innovation is the introduction of new things, ideas or ways of doing something. We show how this definition can be applied to inhaled therapy. We take a look at the past to see what drove innovation in inhaler design and how this has led to the current devices. We look at the current drivers of innovation in engineering, chemistry and digital technology and predict how this may translate to new devices. Can innovation help the healthcare professional manage their patients better? What does the patient expect from innovation in their device? EDUCATIONAL AIMS: To understand the importance of inhaled medication in the treatment of lung diseases. To understand how innovation has helped advance some of the devices patients use today from basic and inefficient designs. To understand the obstacles that prevent patients from receiving optimal treatment from their inhalers. To understand how innovation in inhaler design can lead to improved treatment for patients and widen the range of diseases that can be treated via the inhaled route.