Looking to the future in asthma therapies

VIEWS & REVIEWS

'Radical new developments in the understanding of asthma pathophysiology. .. will no doubt continue to change our models of therapy of asthma in ways in which it is not yet possible to predict' say Paul Gianaris and Joseph Golish from the Cleveland Clinic Foundation in the US. In their review, they have divided future potential asthma therapies into 3 groups:

1. Newer and more potent variations on existing therapies. These include the continued development of improved administration techniques and new delivery routes (such as mini-ultrasonic nebulisers and breath-activated inhalers) for 132-agonists, and the search for agents, such as salmeterol, which provide more prolonged symptomatic relief than currently available agents. In addition, the development of more effective nonsteroidal antiinflammatory agents holds the promise of combination therapy to allow the use of lower doses of inhaled steroids.

2. Agents not traditionally used in asthma therapy. These include antihistamines, cytotoxic agents and calcium antagonists. Although these hold some promise, their degree of usefulness in the clinical setting has yet to be determined. Other agents such as gold salts and magnesium may have potential as adjunctive therapies.

3. New classes of asthma drugs. These are based on a new understanding of the actions of inflammatory mediators. They are intended to intervene at specific points in the inflammatory pathway rather than inducing a global suppression of the immune response. Such agents include PAF antagonists, leukotriene antagonists and vasoactive intestinal peptide which may be an inborn mediator of bronchodilation. Gianaris PG, Golish JA. Treatment of bronchospastic disorders in the 1990s. What does the future hold? Drugs 46: 1-6. Jul 1993 8002",'"

ISSN 0156-270319310814-007/$1.cxf' Adls International Ltd

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INPHARMA8 14 Aug 1993