Therapeutics and Clinical Risk Management (Oct 2022)

Impulse Oscillometry, Small Airways Disease, and Extra-Fine Formulations in Asthma and Chronic Obstructive Pulmonary Disease: Windows for New Opportunities

  • Chetta A,
  • Facciolongo N,
  • Franco C,
  • Franzini L,
  • Piraino A,
  • Rossi C

Journal volume & issue
Vol. Volume 18
pp. 965 – 979


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Alfredo Chetta,1 Nicola Facciolongo,2 Cosimo Franco,3 Laura Franzini,4 Alessio Piraino,4 Carmelina Rossi4 1Clinica Pneumologica, Università di Parma, Parma, Italy; 2UOC Pneumologia, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; 3UOC Pneumologia, Ospedale Guglielmo da Saliceto, Piacenza, Italy; 4Chiesi Italia SpA, Medical Affairs, Parma, ItalyCorrespondence: Alfredo Chetta, Tel +39 0521.703478, Email [email protected]: In recent years, the perspective of management of respiratory disease has been gradually changing in light of the increasing evidence of small airways as the major site of airflow obstruction contributing to the development of both COPD and asthma already in early stages of disease. First and foremost, the evidence is redefining disease severity, identifying small airways disease phenotypes and early signs of disease, and revising prevalence and overall epidemiological data as well. Much effort has been put toward the instrumental assessment of small airways’ involvement and early detection. Several clinical trials have evaluated the advantage of extra-fine formulations which can best target the small airways in uncontrolled asthma and severe COPD. Here, we briefly present a practical overview of the role of the small airways in disease, the most appropriate diagnostic methods for quantifying their impairment, and provide some insight into the costs of respiratory management in Italy, especially in sub-optimally controlled disease.Keywords: asthma, chronic obstructive pulmonary disease, small airways, impulse oscillometry, cost, extrafine particles