Is there a role for inhaled anti-inflammatory drugs in cystic fibrosis treatment?

Introduction: Cystic fibrosis (CF) is a congenital life-limiting, orphan disease affecting 1/2500 – 1/3000 people worldwide with the greatest prevalence in Europe, North America and Australia. The primary reason underpinning the cause of morbidity and mortality of CF patients is associated with recurrent pulmonary inflammation and infection that leads to chronic, progressive lung deterioration and ultimately death of CF patients.

Areas covered: This review aims to explore the potential role for inhaled anti-inflammatory drugs as a more successful treatment option for CF, in comparison with current oral delivery. Specifically, the focus is on ibuprofen, the only nonsteroidal anti-inflammatory drug approved for chronic use in CF. The need for inhalation therapy has also been highlighted with an insight on the reasons and challenges associated with developing an inhalation therapy of nonsteroidal anti-inflammatory drugs (NSAIDs).

Expert opinion: There is a fundamental need to direct research towards development of anti-inflammatory drugs to control inflammation rather than just targeting infection. Development of an inhalable preparation of ibuprofen alone or in combination with an antibiotic holds the potential to be the most effective treatment option among the existing array of therapies available for CF.