Chiesi Farmaceutici is fully committed to the care and improvement of the quality of life of people suffering from respiratory diseases including asthma and COPD (Chronic Obstructive Pulmonary Disease). Asthma and COPD are characterized by an airflow reduction in the respiratory flow and impaired gas exchange in the lungs although they are driven by a different pathophysiological pathway.
According to a 2016 study by the World Health Organization (WHO), there are 339 million people in the world with asthma, while 251million people suffering from COPD, which is predicted as being the third leading cause of mortality by 2030. If measures aimed at reducing disease-related risk factors – i.e. cigarette smoke, noxious gases, fine dust particles - are not adopted, it is estimated that COPD-related deaths will increase by 30% in the next years¹.
In search of continuous improvement in patient health, Chiesi is researching and developing new therapeutic solutions based on the innovative Modulite® technology, which allows the inhaled pressure solution containing inhaled corticosteroid and long-acting beta-mimetic to be delivered in the form of extra-fine particles. Chiesi's patent is NEXThaler - a dry powder inhaler (DPI), through which the same active substances are delivered to the lungs, also in the form of extra-fine particles. Placing the patient and his needs in focus, Chiesi has developed and proposed a fixed triple combination of an inhaled corticosteroid, a long-acting beta-mimetic and a muscarinic antagonist for the treatment of patients with COPD and asthma.
Asthma is a chronic inflammatory disease characterized 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. Consequently, 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 meets irritants. In particular, predisposing factors are genetic, 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 lungs. Asthma occurs more frequently in children and adolescents, although in recent years diagnosis in adults and the elderly are becoming more and more frequent².
COPD is a chronic progressive respiratory disease characterized by a persistent bronchial obstruction (irreversible), associated with an increased chronic inflammatory response of the airways to noxious particles or gas. The classic symptoms associated with COPD are dyspnea, fatigue, chronic coughing with or without sputum. In some cases, an acute worsening of the abovementioned symptoms may occur, triggering COPD exacerbation. A double mechanism is at work in the bronchial obstruction in COPD patients: on one hand, an inflammation of the small airways together with the thickening of the airways walls and increased airflow resistance may occur. On the other, a progressive destruction of lung parenchyma (emphysema) associated with the loss of elastic retraction of the lung may take place. It is important to underline that both mechanisms may coexist, leading to a global airflow reduction throughout the lungs. But what are the risk factors associated with COPD? The most important risk factors are cigarette smoke, as well as exposure to domestic pollutants (linked to the cooking of food or gas emitted from biofuel combustion) or environmental pollution. Secondary factors are age, sex, socio-economic status, respiratory infections, asthma. Part of the patients may have genetic predisposition to the disease. In general, COPD patients are more prone to developing cardiovascular diseases, osteoporosis, diabetes, lung cancer and bronchiectasis, which in turn increase hospitalization and/or risk of death. Unlike asthma, COPD is a late onset disease, being more common among adults (it does not exist among young patients), since its development involves a slow and progressive exposure to risk factors. ³