Thanks to Chiesi, a new therapeutic option for patients with uncontrolled asthma is available in Italy, which promises to make it easier to take the medicines needed to manage the disease. These are patients – as explained in a press release from the company – who, despite therapy with a double combination (ICS+LABA), are at risk of frequent respiratory crises and worsening of lung function. The new compound is a unique triple extrafine BDP/FF/G combination in a single inhaler that has been shown to reduce severe exacerbations by one-third (33.5%) in asthmatics with persistent airflow limitation. The novelty was presented in Milan by Chiesi Italia, the Italian branch of the Chiesi Group.
The fixed triple combination BDP/FF/G combines three active ingredients in one inhaler: an inhaled corticosteroid/ICS (beclomethasone dipropionate, BDP), a long-acting beta2-agonist bronchodilator/LABA (formoterol fumarate, FF) and a long-acting muscarinic antagonist/LAMA (glycopyrronium, G).
Inhaled corticosteroids reduce airway inflammation and reduce the risk of exacerbations; bronchodilators, on the other hand, act on bronchial obstruction, reducing symptoms. The drug is available in two different strengths of the inhaled corticosteroid.
Tiny particles
«Asthmatic patients who do not achieve adequate disease control with the ICS/LABA combination now have the opportunity to use, with the use of a single inhalation device, triple therapy, i.e. the combination of ICS/LABA/LAMA , with an enhancement of therapeutic efficacy», explained Paola Rogliani, full professor of diseases of the respiratory system at the University of Rome Tor Vergata. «The triple fixed combination represents an optimization of inhalation therapy having demonstrated superior efficacy compared to the double ICS/LABA combination in patients with uncontrolled asthma, with an impact in the reduction of severe exacerbations and improvement in lung function. Another peculiarity of this triple fixed combination is the extra-fine formulation characterized by small inhalation particles: this guarantees the deposition of the active ingredients with a wide distribution that also reaches the peripheral airways, involved with structural and functional anomalies in patients with asthma and asthma unchecked”.
Pathology on the rise
Asthma is a chronic inflammatory disease of the airways that affects 300 million people worldwide. In Italy there are an estimated 4.6 million adult asthmatic patients, equal to 7.9% of the population (there were 4.8% in 2010). Of these, about 10% have a severe form. Due to the inflammation, in the presence of triggering factors, a narrowing of the bronchial tubes (bronchospasm) occurs, which obstructs the passage of air causing shortness of breath, wheezing and wheezing, feeling of tightness in the chest and coughing.
“The triggering factors of an asthmatic crisis are primarily viral infections of the respiratory tract, but also exposure to allergens such as mites, pollen and dust”, explains Francesco Blasi, full professor of respiratory diseases at the University of Milan. «An asthma attack represents an acute worsening of symptoms and respiratory function compared to the patient’s usual condition. If the disease is not controlled, the exacerbations can recur over time and can also be very serious, causing considerable discomfort for the patient and also causing visits to the emergency room or hospitalizations”.
Underestimating the disease
«Patients who are treated appropriately and regularly can lead a normal life, without limiting themselves in their daily attitudes and actions, from work to leisure time, to sport. However, in a significant percentage of patients, asthma control remains unstable and this is largely due to under-treatment of the disease», says Claudio Micheletto, director of pulmonology at the Integrated University Hospital of Verona.
«Among the major problems in asthma management is poor adherence to inhaled therapy: many patients tend to underestimate the disease and, in the inter-critical phases, abandon the basic therapy consisting of the association of inhaled steroids and bronchodilators. The availability of a triple therapy which allows the use of a single inhaler and with two different dosages, represents an important simplification for the patient, to the benefit of therapeutic adherence, as well as greater efficacy of the treatment”.
More adherence to therapies
In Italy, adherence to therapy continues to be a highly critical element, with levels below 20%. An estimated 24% of exacerbations and 60% of asthma-related hospitalizations are attributable to poor adherence. Evidence shows that using a single inhaler significantly increases adherence rates; furthermore, economic analyzes show that the single inhaler is associated with reduced use of healthcare resources and is cost-effective compared to multiple inhaler therapies.
“Failure to control asthma can greatly affect sufferers. Because of the symptoms and the fear of incurring an attack, perhaps so serious as to have to go to the emergency room, many patients reduce their activities, limit social relationships, are absent from work, give up sports, triggering a vicious circle which compromises the quality of life and the state of health – explains Simona Barbaglia, president of the national patient association “Breath together” – Education and dialogue with the patient are essential for acquiring awareness of their disease and thus allowing them to manage and control it, improving adherence to therapy. Even the emotional and psychological aspects should not be neglected for effective care ».
Patients first
«We are proud to be able to offer patients an important result of Chiesi’s Italian research that satisfies a therapeutic need of great importance for people suffering from more severe forms of asthma – says Raffaello Innocenti, CEO and managing director of Chiesi Italia – The launch of the he unique triple association ICS-LABA-LAMA extrafine in a single inhaler with an indication for asthma confirms our desire to provide patients with increasingly effective, safe and easy-to-take therapeutic options. In line with our values as a certified B Corp company, we are fully committed to improving the quality of life of people affected by respiratory diseases, an area in which we are recognized as a world leader».