Innovating Inhalation: The Future of Pulmonary and Nasal Drug Delivery
Non-invasive drug delivery via pulmonary and nasal routes is increasingly in demand; however, while there has already been significant innovation within the sector, even more is required to meet future needs.
Chronic respiratory disorders, such as chronic obstructive pulmonary disease, asthma, allergic rhinitis, and sinusitis, are becoming increasingly prevalent and considered to be “major contributors to the growing global burden of non-communicable diseases” (1). However, these disorders are highly treatable and can be controlled effectively with appropriate therapeutic regimens.
For many with chronic conditions, the treatment burden can be overwhelming, meaning that greater prevalence is placed on more convenient, non-invasive dosage forms that are patient friendly. Therefore, pulmonary or nasal administration routes are preferred as they provide site-specific delivery of drugs, rapid onset of action, improved bioavailability, and fewer systemic side effects (2).
Additionally, thanks to the benefits offered by non-invasive delivery to the respiratory tract or nasal mucosa, the potential applications of these delivery options are broadening to other therapeutic areas, driving even greater innovation into the field.
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Innovation in Inhalation Delivery
Within the pulmonary space, there has been a great amount of innovation around how to generate and deliver aerosols, notes Kamaal de Silva, Principal Mechanical Engineer at Springboard — a medical device design and development consultancy that is part of the Sanner Group. Using soft mist inhalers as an example, de Silva highlights how these are providing improved lung deposition compared with more conventional delivery methods while also minimizing inspiratory efforts.
“Then, there’s vibrating mesh nebulizers,” de Silva adds. “These nebulizers are typically replacing the sort of jet nebulizers that were popular two decades ago. They’re much more efficient and they generate much more consistent droplet sizes.”
Focusing on nasal drug delivery, Richard Johnson, Chief Scientific Officer and Founder of Upperton Pharma Solutions remarks that there are many exciting advances happening in the field, such as targeting into specific regions of the nose, systemic delivery via the nose, and the development of drug powder dosage forms for nasal drug delivery. “The emergence of dry powder devices is enabling us to deliver a much wider range of different types of drugs,” he says. “We’re now talking of more complex and new formulations containing biologics, for example, oligonucleotides, proteins, vaccines, a whole new array of drugs that are being delivered nasally for local and systemic delivery.”
Overcoming Stability Issues with Large Molecules
To deliver larger, more complex drug products nasally, it is important to overcome the issue with stability, Johnson remarks. “Quite often, with these biologics, if you have an aqueous solution or a solution of that biologic, you can't put it into a solvent for delivery, it's got to go into the nose in an aqueous solution; but, in the aqueous solution it can be quite unstable,” he says.
“Now, with these new next generation devices, we're seeing the emergence of dry powder formulations [that] are much more stable,” Johnson comments. “So, dry powder formulations that can be delivered in a dry powder device really have massively increased the interest in delivery of these biologics into the nose.”
The shear forces involved with pulmonary delivery devices has so far proven to be too much for biologics, emphasizes de Silva. “A vibratory mesh nebulizer has quite a lot of shear force in it to actually create the particles for inhalation, [so, the biologics] don’t really survive,” he says.
There are similar issues for dry powder inhalers, de Silva confirms. “If you wanted to deliver biologics, you would have to make a carrier that doesn’t degrade the molecule,” he adds. “And, also if you use classic techniques to micronize, like spray drying, the molecules also wouldn’t survive.”
Greater Regulatory Scrutiny over Deposition
For targeted delivery, Johnson expects that there may be increasing regulatory scrutiny over the precise location for drug deposition once it has been delivered. “With pulmonary delivery into the lung, there’s already existing techniques and tests where you can test to see where the powders or liquids coming out of the device deposit in the lung — the next generation impactor — but those tests don’t really exist in nasal drug delivery. So, regulators and researchers are now looking at developing new models for deposition through nasal delivery,” he reveals.
“The nasal anatomy is actually quite complex, you’ve got the vestibule, the olfactory region, the turbinates, and then, at the back of the nose, you’ve got the nasopharynx,” Johnson asserts. “So, the different targets within the nose and understanding whereabouts in the nose you're targeting and how much of your dose is being delivered into those different areas is currently a very interesting scientific question.”
Sustainability
Within pulmonary drug delivery there are well known issues around propellants and their impact on global warming, which have about 100 to 300 times greater global warming potential than carbon dioxide, de Silva reveals. While there has been a lot of work into potential new propellants, as with most aspects of the medical device industry, implementing these newer, greener options into devices will take time, he adds.
“In the meantime, there has been a shift of trying to get people to move to dry powder inhalers,” de Silva continues. However, these types of inhalers require much more suction pressure to be effective, which is problematic for some patients who are used to the pressurized metered dose inhalers, he notes.
Thinking about the physical device, de Silva highlights the industry-wide focus on ensuring that less material is being used in packaging and that device designs are optimized as much as possible to be as environmentally friendly as they can be. Additionally, de Silva raises the point that there are many devices that are thrown away as a result of adherence issues; therefore, improving the design from a user perspective can also help reduce such waste and reduce carbon footprint.
For nasal drug delivery, sustainability concerns are focused around the device as propellants aren’t used, Johnson specifies. “We’ve seen over the past year or so, particularly in the dry powder area, the emergence of single-use drug powder devices, primarily for use in rescue/emergency situations where you can fire a single drug powder dose into a patient that needs a rescue drug,” he says. “The challenge here becomes, if it’s a one-shot device, you’ve got a lot of plastic.”
To counteract the sustainability issues around such devices, new multi-dose dry powder devices are being developed, Johnson reveals. “The emergence of these multi-dose devices will really answer some of the sustainability concerns and will put peoples’ minds at ease while also opening up new avenues and opportunities for nasal drug delivery,” he summarizes.
References
Zhai, Y.; Zhu, C.; Zhu, T.; et al. Global, Regional, and National Burden of Chronic Respiratory Diseases, 1990–2021 and Predictions to 2035: Analysis of Data from the Global Burden of Disease Study 2021. Ann. Med. 2025, 57 (1), 2530225.
Emergen Research. Inhalation and Nasal Spray Market. Market Research Report, July 3, 2025.
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