In its return to the Edinburgh International Conference Centre after two years of online-only meetings, the Drug Delivery to the Lungs conference looked toward the future, focusing on scientific and technical innovations that will influence inhaled and nasal drug development for years to come.
The meeting drew a record crowd, with approximately 130 virtual delegates joining more than 900 OINDP specialists who met face-to-face in Edinburgh to enjoy the all of the talks, plus a bustling exhibition of products and services, scientific posters, and networking opportunities. According to DDL 2022 Committee Chair Gary Pitcairn’s welcome presentation, 433 attendees from the UK, 400 from the EU, 82 from the US, 67 from Asia, and 12 from Australia had registered by the beginning of the meeting.
Looking to the future of inhaled delivery
Federico Lavorini of the University of Florence opened the scientific program with his talk titled “Drug Delivery Over the Last 100 Years . . . and the Future,” which he described as a doctor’s perspective on innovations in inhaled drug delivery over the last century.
Observing that patients still have difficulty using devices correctly, and health care providers still have difficulty explaining their use, Lavorini mentioned a few innovations that have been shown to make inhalers easier to use. For example, he noted, the Ellipta DPI has one less operating step than the Diskus device, and even one less step improves the patient’s ability to use the inhaler. However, he said, the continuing inability of patients to use inhalers as intended is “very bad.”
One major issue he cited is the difference between real life use of inhalers and the way that they are used in clinical trials, where patients get as much instruction as necessary to use the device properly. When health care providers focus on prescribing the inhaled therapy with the best efficacy as shown in a trial — and that is exactly how most decide which inhaler to prescribe, Lavorini said — patients in the real world may suffer.
Lavorini asserted that “Most asthma and COPD patients are unintentionally non-adherent” and placed part of the blame on modern instruction leaflets, which he called “undreadable” and “boring.” To demonstrate his point, he played several clips from the Bond movie “Casino Royale” showing the villain repeatedly mis-using an MDI. “The clinical impact is terrible; it’s a nightmare,” he said.
