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Menarini has for years been engaged in the therapy of respiratory diseases, particularly Asthma and Chronic Obstructive Pulmonary Disease (COPD).
With this in mind the Company has focussed part of its energy on research and clinical trials with the aim of optimising existing therapeutic tools and of creating new, innovative drugs and therapeutic aids. Menarini's interest in the respiratory area is directed at scientific and cultural updating; it organises seminars and congresses with speakers of national and international fame, and divulges various types of informative material.
Asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of breathlessness. During an asthma exacerbation the airways thickens, the muscles of the airways contract and mucus clogs the airways, making breathing difficult. The airways become hypersensitive to environmental changes, causing wheezing and coughing. Many factors can cause an asthma exacerbation, such as viral infections, exposure to allergens (such as dust mites or pollen), smoking, air pollution. The symptoms of asthma are variable and often worsen during the night and the early morning with a severity of the disease characterized by individual variability.
COPD is a chronic lung disease characterized by progressive obstruction of the airways, making breathing difficult. The most important risk factor of COPD is cigarette smoking, but also the occupational exposure to irritants and environmental pollution have been recognized as a cause of the disease. COPD characteristic symptoms are chronic cough, sputum production and a progressive breathlessness, initially noted on exertion, which may strongly interfere with daily activities. In the disease progression may occur exacerbations, characterized by increased cough and sputum, wheezing, breathlessness and sometimes fever. Given the progressive nature of COPD, diagnosis and early treatment are essential to prevent complications and exacerbations, which often leads to patient hospitalization.
Asthma and COPD are both chronic diseases characterized by airway obstruction. The obstruction, however, has different characteristics: asthma is often completely reversible (spontaneously or by treatment), whereas in COPD the obstruction isn’t fully reversible and usually, if exposure to noxious agents continues, gets worse gradually. Both in asthma and in COPD an airways inflammation is present, however even this aspect shows very different characteristics between the two diseases.
Menarini has committed in technological and therapeutic developement of aerosol therapy devices: by prioritizing the needs of the patient in combination with targeted therapy to the care of asthma and chronic bronchitis has developed and marketed the spacer named Fluspacer, an innovative spacer which help the patients to use aerosols medications. The constant updating of the medical profession sees Menarini engaged in major projects like the development by Menarini Foundation of conferences on issues of global importance.
Severe asthma attacks may be life-threatening. Treatment of asthma attacks, especially of severe or persistent, must be carried out under medical supervision. Asthmatic patients must always carry a short-acting bronchodilator (e.g. salbutamol) with them to be used in the event of an asthma attack (2-4 puffs every 20 minutes, as many as 3 times during the first hour). The use of drugs as required must be limited to controlling occasional symptoms. If the day-time symptoms occur more than twice a week, and it is necessary to use the drug as required more than twice a week, the basic asthma treatment must be reassessed and /or implemented.
Asthma is a chronic and variable disease. Home asthma monitoring systems include a clinical diary and measuring of the peak expiratory flow (PEF). By filling out the Asthma Control Test (ACT) questionnaire, patients are able to assess the level of control reached themselves. Clinical measures include medical check-ups, spirometry, measuring of bronchial reactivity, and dosing of inflammatory markers. The frequency of the check-ups must be agreed to with the doctor depending on the nature of the asthma, its therapy and the current therapy.
The guidelines foresee a gradual approach and therefore the dose and type of the drugs prescribed must be modified according to the level of asthma control reached. If the day-time symptoms occur more than twice a week, if there are also night-time symptoms, and if it is necessary to use the drug as required more than twice a week, the basic asthma treatment must be reassessed. The patient, together with the doctor, must agree on how to adapt the treatment according to the level of control of the patient’ asthma.
The most frequent and common symptoms of asthma are: breathlessness (dyspnoea), cough, wheezing, a sense of chest constriction, both at rest and after physical exertion. These symptoms may occur without warning, they may last for a few minutes or even days, they may clear up spontaneously or after treatment, they may be episodic or continual, seasonal or present throughout the year. The characteristics of asthma are its variability in terms of frequency and duration of the symptoms, of being triggered by specific factors, worsening at night, and responding to pharmacological treatment. In some patients the only symptom may be a dry, irritating cough, or wheezing only after physical exertion.
When correctly diagnosed and treated, asthma should not limit the patient’s life. By knowing the cause of your own asthma you will be able to take preventive measures (purifying the environment of allergies from mites, premedication before sporting activities, etc.) and implementation of the most suitable treatment. To achieve and maintain a good control of asthma it is important to adopt a healthy lifestyle by not smoking, carrying out regular physical activity, keeping body weight under control and taking medicinal products regularly.
Asthma symptoms may be induced or triggered by a variety of specific elements (e.g. allergen, drugs, gastro-oesophageal reflux, etc.) Asthma symptoms may be induced by nonspecific elements (e.g. viral infections, cigarette smoke, atmospheric pollution, irritant chemical substances, the cold, physical exertion, etc.). It is essential for every patient to know the factors that could trigger an asthma attack and eliminate them, or if not possible, reduce them to a minimum.
Inhalation treatment allows the drug to directly reach the target organ, and if implemented correctly, reduce the risk of systemic effects. Today there are numerous inhalators available on the market and despite having different properties, they all offer adequate administration of the drug. Individual preference and user-friendliness may influence the effectiveness of the drug, compliance with the treatment and control of the disease in the long term. It is essential carefully read the illustrative leaflet accompanying the inhaler and check with your doctor that you are using it correctly.
Asthma is under control when there are no symptoms (or at least minimal symptoms), no flare-ups (or at least very rare flare-ups), no emergency visits or hospitalisation due to asthma, no need (or minimal) for additional use of the bronchodilator as required, no curtailing of daily activities (including physical and sporting activities), and when there is a daily variation in the Peak Expiratory Flow (PEF) of less than 20% and normal spirometric values (or the best possible). Scientific evidence demonstrates that with pharmacological treatment, these goals can easily be achieved in the majority of patients
Asthma is a persistent/chronic disease: this means that it can be controlled but not cured. Moreover, asthma is a variable disease, characterised by stages of worsening when the symptoms appear (asthma attacks or asthma flare-ups), which alternate with periods of complete wellbeing. Persistent asthma is an inflammatory disease, and therefore treatment must be continued even in the absence of symptoms.
Asthma therapy foresees the use of basic drugs and drugs to be used as required. The former (corticosteroid inhalers, long-acting bronchodilators, antileukotrienic drugs, theophyllines, chromones, anti IgE monoclonal antibodies) are drugs taken in an ongoing manner for the purpose of clinically keeping the asthma under control, thanks to their anti-inflammatory and/or bronchodilator effect. The drugs to be used as required for relieving the symptoms (short-acting bronchodilators) do not have any effect on the inflammation and the need to use them frequently means that the basic therapy (if already administered) is not sufficient for controlling the disease and must be changed and/or implemented. Cortisones to be taken via normal means (tablets, vials, etc.) are drugs to be reserved in case of severe asthma attacks or severe asthma flare-ups; in view of their long-term side effects, the use of these drugs should in any case be limited as much as possible.