Pulmatrix, Inc.’s chief scientific officer, Dr. David L. Hava, described in an article recent advances in drug delivery strategies — such as nebulizers for inhaled delivery — that are helping to treat bacterial and fungal lung infections, and are particularly relevant to people with diseases like cystic fibrosis (CF). The article, “Advances in Pulmonary Delivery of Inhaled Anti-Infectives,” was published in the ONdrugDelivery Magazine.
Pulmonary infectious diseases originating from bacterial, viral, and fungal pathogens affect millions worldwide. Such infections also pose considerable risk for patients with respiratory conditions such as CF, leading to disease exacerbations and worsening lung function.
“Patients with CF become colonized with a number of different bacteria early in life and eventually become chronically colonized with pathogens,” Dr. Hava wrote, according to a press release.
The biopharmaceutical industry, Dr. Hava said, has been developing ways to more effectively deliver antibiotics, and antiviral and antifungal agents, directly to the lungs of patients. He specifically mentions as an example jet nebulizers, devices that turn liquid solutions of antibiotics into a fine mist that can be inhaled. Nebulized antibiotic formulations include Novartis AG’s tobramycin and Gilead’s aztreonam, with other drugs using now in clinical testing.
“The development of nebulised inhaled antibiotics provided a major advance to address significant unmet need in CF. While nebulised products are suitable for patients in a hospital setting, such as those with ventilator-associated pneumonia (VAP), the formulation of inhaled antibiotics into a portable, user-friendly format is desired to reduce treatment burden and improve compliance,” Dr. Hava wrote.
Inhaled delivery also reduces the likelihood of medication side effects and drug-drug interactions, he said.
But there are some limitations in this delivery system, he wrote, and companies — including Novartis, Acorda Therapeutics, and Savara — are developing formulations using dry powders. Pulmatrix is taking an approach that uses its iSPERSE technology, thought to offer an improvement over current technologies because its particles are engineered to be small, dense, and easily dispersible once inhaled, resulting in improved drug delivery to the airways.
Currently, Pulmatrix is developing an inhaled product using an antifungal drug, itraconazole, as a CF therapy. Recent studies have show that oral itraconazole is effective in treating CF patients with allergic bronchopulmonary aspergillosis (ABPA), but the high oral doses needed to move an effective amount of the drug from the bloodstream to the lungs can cause severe side effects, including liver toxicity.
The Pulmatrix drug candidate, PUR1900, “has the potential to provide a valuable addition to current treatment options for pulmonary fungal diseases,” Dr. Hava concluded.