Elsevier

Journal of Cystic Fibrosis

Volume 8, Issue 5, September 2009, Pages 295-315
Journal of Cystic Fibrosis

Inhaled medication and inhalation devices for lung disease in patients with cystic fibrosis: A European consensus

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Abstract

In cystic fibrosis inhalation of drugs for the treatment of CF related lung disease has been proven to be highly effective. Consequently, an increasing number of drugs and devices have been developed for CF lung disease or are currently under development. In this European consensus document we review the current status of inhaled medication in CF, including the mechanisms of action of the various drugs, their modes of administration and indications, their effects on lung function, exacerbation rates, survival and quality of life, as well as side effects. Specifically we address antibiotics, mucolytics/mucous mobilizers, anti-inflammatory drugs, bronchodilators and combinations of solutions. Additionally, we review the current knowledge on devices for inhalation therapy with regard to optimal particle sizes and characteristics of wet nebulisers, dry powder and metered dose inhalers. Finally, we address the subject of testing new devices before market introduction.

Keywords

Cystic fibrosis
Inhaled medication
Inhalation devices

Cited by (0)

This meeting, held on April 4 to 6, 2008 in Artimino, Tuscany, Italy, was organized by the European Cystic Fibrosis Society. Supported by AOP Orphan Pharmaceuticals AG, Austria; Aradigm Corporation, USA; Bayer Healthcare, Germany; Boehringer Ingelheim GmbH, Germany; Chiesi Farmaceutici, Italy; Forest Pharmaceuticals Inc., USA; Gilead Sciences, USA; Grünenthal GmbH, Germany; Novartis UK, Profile Pharma Limited/Respironics, UK; Roche, Switzerland.

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Baroukh Assael, Cystic Fibrosis Center, Verona, Italy; Ian Balfour-Lynn, Royal Brompton & Harefield NHS Trust, Sydney Street, London, United Kingdom; Gabriel Bellon, Hôpital Debrousse, Lyon, France; Celeste Barreto, Hospital de Santa Maria, Lisbon, Portugal; Cesare Braggion, Ospedale Civile Maggiore, Verona, Italy; Steven Conway, St James University Hospital, Leeds, UK; Christiane De Boeck, University Hospital Gasthuiberg, Leuven, Belgium; Gerd Döring, Institute of Medical Microbiology and Hygiene, Eberhard-Karls-Universität, Tübingen, Germany; Jean-Christophe Dubus, Faculté de Médecine, Marseille, France; Irmgard Eichler, EMEA, London; Mark Elkins, Royal Prince Alfred Hospital, Sydney Australia; Henderik Frijlink, University of Groningen, Groningen, The Netherlands; Charles Gallagher, St Vincent's Hospital, Dublin, Ireland; Silvia Gartner, University Hospital Vall d'Hebron, Barcelona, Spain; David Geller, Nemours Children's Clinic, Orlando, USA; Matthias Griese, University of Munich, Munich, Germany; Harry Heijerman, Haga Teaching Hospital, The Hague, The Netherlands; Lena Hjelte, Karolinska University Hospital Huddinge, Stockholm, Sweden; Margaret Hodson, Royal Brompton Hospital, London, United Kingdom; Niels Høiby, Rigshospitalet, Copenhagen, Denmark; James Littlewood, St. James's University Hospital, Leeds, UK; Anne Malfroot, Academisch Ziekenhuis, Vrije Universiteit Brussel, Brussels, Belgium; Alexander Möller, University Children's Hospital, Zurich, Switzerland; Petr Pohunek, Charles University 2nd Medical School, Prague, Czech Republic; Tanja Pressler, Rigshospitalet, Copenhagen, Denmark; Alexandra Quittner, University of Miami, Miami, USA; Felix Ratjen, Hospital for Sick Children, Toronto, Canada; Martin Schöni, University of Berne, Berne, Switzerland; Giovanni Taccetti, Ospedale Meyer, Florence, Italy; Harm Tiddens, Erasmus University Medical Center, Rotterdam, The Netherlands; Daan Touw, Apotheek Haagse Ziekenhuizen, The Hague, The Netherlands; Elsbeth Westerman, Apotheek Haagse Ziekenhuizen, The Hague, The Netherlands.