Bronchitol

Question

The new drug bronchitol is already available in Australia. Will it be available on the European market soon?

Answer

Bronchitol is a new medicine that is being administered via inhalation of a dry powder. These capsules need to be taken one after the other in rapid succession over 2-3 minute, and therefore the administration is faster than with classic nebulisation (10-15 minutes). As you probably know, secretions of patients with CF are tenacious and difficult to cough up. Bronchitol is a sugar (mannitol) that is not being used or digested by humans. When this mannitol powder is being inhaled, water is drawn to the mucus layer thereby looseing the secretions. It then becomes easier for the patient to cough up the secretions. Large scale clinical trials have demonstrated that inhalation of mannitol will improve lung function and diminish the number of exacerbations of lung infection. The improvement in lung function was on average 8 % over the course of a year. Also in patients who already used DNase there was an improvement of lung function of about 5%.

All medicines taken by inhalation can -in some people -cause narrowing of the airways. This thus can also happens after inhalation of mannitol. At the start of the treatment it should thus be checked whether the patient tolerates the inhalation of mannitol. When he does tolerate the medication, this will continue to be the case throughout the treatment. The medicine mannitol was developed in Australia and is already available on the market there. In Europe and in US negotiations with responsible authorities are ongoing (EMA and FDA) but there is at present not yet an approval for use. We hope that it will occur soon.

Kind regards,

Dr. Mieke Boon
Prof. K De Boeck

28.04.2011