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Chiesi group is fully determined to serve the ailing humanity suffering from asthma and COPD (Chronic obstructive pulmonary disease). Asthma and COPD are characterized by a reduction in the respiratory flow although they are driven by a different pathophysiological pathway.

Asthma is one of the major non-communicable diseases. It is a chronic disease of the air passages of the lungs which inflames and narrows them. According to the latest estimates of the WHO (World Health Organization), there are 235 million people across the globe - mainly children - suffering from asthma. Most asthma related deaths occur in low and lower middle income countries. According to the latest WHO estimates, released in December 2016, there were 383,000 deaths due to asthma in 2015.

Whilst 64 million people suffering from COPD (WHO 2004 estimate), 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 - are not adopted, it is estimated that COPD related deaths will increase by 30% in the next 10 years.

In the search for continued improvement in the health of patients, Chiesi researches and develops new therapeutic solutions based on the innovative formulation technology Modulite®, which allows the creation of Spray Solutions (pMDI, pressurized Metered Dose Inhaler) Breath actuated DPIs (Dry Powder Inhalers) for inhalation able to deliver Extra-Fine Particles.

 

Asthma at Glance

Asthma is a major non-communicable disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. Symptoms may occur several times in a day or week in affected individuals, and for some people become worse during physical activity or at night. During an asthma attack, the lining of the bronchial tubes swell, causing the airways to narrow and reducing the flow of air into and out of the lungs. Recurrent asthma symptoms frequently cause sleeplessness, daytime fatigue, reduced activity levels and school and work absenteeism. Asthma has a relatively low fatality rate compared to other chronic diseases. The fundamental causes of asthma are not completely understood. The strongest risk factors for developing asthma are a combination of genetic predisposition with environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways, such as:

  • indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander)
  • outdoor allergens (such as pollens and moulds)
  • tobacco smoke
  • chemical irritants in the workplace
  • Air pollution.

Other triggers can include cold air, extreme emotional arousal such as anger or fear, and physical exercise. Even certain medications can trigger asthma: aspirin and other non-steroid anti-inflammatory drugs, and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine).

Although asthma cannot be cured, appropriate management can control the disease and enable people to enjoy a good quality of life. Short-term medications are used to relieve symptoms. Medications such as inhaled corticosteroids are needed to control the progression of severe asthma and reduce asthma exacerbation and deaths.

People with persistent symptoms must take long-term medication daily to control the underlying inflammation and prevent symptoms and exacerbations. Inadequate access to medicines and health services is one of the important reasons for the poor control of asthma in many settings.

Medication is not the only way to control asthma. It is also important to avoid asthma triggers - stimuli that irritate and inflame the airways. With medical support, each asthma patient must learn what triggers he or she should avoid.

 

COPD at a Glance

Chronic obstructive pulmonary disease is a lung disease that is characterized by a persistent reduction of airflow. The symptoms of COPD are progressively worsening and persistent breathlessness on exertion, eventually leading to breathlessness at rest. It tends to be under­diagnosed and can be life threatening. The more familiar terms “chronic bronchitis” and “emphysema” have often been used as labels for the condition.

The primary cause of COPD is tobacco smoke (including second­hand or passive exposure). Other risk factors may include:

  • Indoor air pollution (such as solid fuel used for cooking and heating)
  • Outdoor air pollution
  • Occupational dusts and chemicals (such as vapors, irritants, and fumes)
  • Frequent lower respiratory infections during childhood

Chronic Obstructive Pulmonary Disease develops slowly and usually becomes apparent after 40 or 50 years of age. The most common symptoms of COPD are breathlessness (or a "need for air"), chronic cough, and sputum (mucous) production. Daily activities, such as walking up a short flight of stairs or carrying a suitcase, and even daily routine activities can become very difficult as the condition gradually worsens. Sufferers also frequently experience exacerbations, that is, serious episodes of increased breathlessness, cough and sputum production that last from several days to a few weeks. These episodes can be seriously disabling and result in need for urgent medical care (including hospitalization) and sometimes death.

Chronic obstructive pulmonary disease is usually suspected in people who experience the symptoms described above and can be confirmed by a breathing test called "Spirometry" that measures how much and how quickly a person can forcibly exhale air.

Chronic Obstructive Pulmonary Disease is not curable. However, available medical and physical treatments can help relieve symptoms, improve exercise capacity and quality of life and reduce the risk of death. The most effective and cost-effective available treatment for COPD in people who continue to smoke is smoking cessation. Smoking cessation can slow down the progress of the disease in smokers and decrease COPD-related deaths. In some, but not all, people with COPD, treatment with inhaled corticosteroid medicines has a beneficial effect.

PRODUCTS

Foster®

Foster is a fixed combination of Beclomethasone Dipropionate 100mcg (anti-inflammatory Inhaled Corticosteroid) plus formoterol fumarate 6mcg (Long acting bronchodilator). The Foster pMDI is only brand, based on Modulite Technology which releases extra fine particles that covers both large and small airways and provides prompt Asthma Control. Foster is only product which can:

  • REACH Small Aiways,
  • TREAT both Large & Small Airways
  • Provide Greater Benefits

The product is indicated for the treatment of asthma both as a maintenance (1 or 2 puffs twice-daily) and MART (Maintenance and Reliever Therapy) posology scheme. The latter allows the use of Foster also as reliever therapy (6 extra puffs as needed).

Clenil® Compositum for Aerosol

(sterile suspension for nebulization in emergency -Salbutamol 1600mcg + BDP 800mcg) is an ideal combination of Bronchodilator (salbutamol) and anti-inflammatory (BDP) which is recommended as first choice to manage asthma in emergency. The synergism of two active ingredients potentiate total effect and provides better of asthma.

Atem® 0.025% Nebuliser Solution

Each 2ml vial of Atem contains sterile Solution for nebulization – Ipratropium Bromide 500mcg Ipratropium bromide is a competitive antagonist of muscarinic acetylcholine receptors. It exhibits its greatest potency on bronchial receptors, whether given inhaled or through nebulizer but causes no tachycardia. No anticholinergic effects have been observed on cardiac function.

Rinoclenil®

(nasal spray BDP 50mcg & 100mcg) is available in suspension form and is effective remedy for Prophylaxis and treatment of allergic seasonal and perennial rhinitis and vasomotor rhinitis. Rinoclenil (BDP) administered by nasal application mainly deposits in the nostrils, therefore it is characterized by a high local activity that is not associated to any significant systemic effects.

Bamifix®

Bamifix, a methylxanthinic derivative contains Bamifylline 600mg, is an effective treatment for patients with bronchial asthma and chronic bronchitis. Bamifix carries out bronchospasmolytic action on smooth musculature and blocks the action of bronchoconstriction mediators.  Bamifix is absorbed rapidly and achieve maximum plasma concentration in one hour, Due to high liposolubility Bamifix disappears rapidly from plasma to be distributed largely in the tissues thus allowing longer elimination half-life which makes Bamifix effective at two daily administrations

Bamifix is 50 times more potent as compared to theophylline due to its high therapeutic index, with no exciting effects on CVS and no stimulating effects on CNS. Usual dosage of Bamifix is one dragee in the morning and one in the evening, Dosage can vary from 900 to 1800 daily according to medical advice

Clenil® 250

(pMDI, Modulite® - BDP 250mcg) is based on Modulite Technology. Modulite is a Chiesi proprietary Technology platform for the development of HFA metered dose inhalers that allows modulation of the size and speed of the delivered particles and offers key advantages like:

 

  • Stability
  • Dose delivery Uniformity
  • Flexibility in Tailoring (modulating) particle size
  • Distribution of the cloud generated on actuation

 

Clenil 250 is available in solution formulation, providing superior efficacy and better Hand Lung Coordination.

Clenil A

(sterile suspension for nebulization - BDP 800 mcg) is the first mono dose for aerosol therapy which ensures the effective management of asthma, allergic or vasomotor rhinitis and inflammatory affections of nasal and paranasal cavities.  It ensures marked anti-inflammatory & anti-allergic action due to direct topical action on bronchial and nasal mucosa. Clenil A is an ideal choice to manage asthmatic conditions efficiently.

 

Clenil Compositum HFA

(pMDI BDP + Salbutamol 50/100 & 250/100 mcg) is inhalation therapy to manage asthma and asthmatic exacerbations promptly, effectively and safely. According to GINA Guidelines Clenil Compositum HFA is a valid option in Intermittent and mild asthmatic cases.