Emerging drugs for treating the acute respiratory distress syndrome

ABSTRACT

Introduction: The acute respiratory distress syndrome (ARDS) is a common and catastrophic condition, with a high mortality rate and economic burden on society. Despite 50 years of study, there is no specific pharmacological therapy for ARDS.

Areas covered: This review outlines the definitions, epidemiology, risk factors and pathophysiology of ARDS. The priority of developing a clinically-relevant model for ARDS to test pre-clinical candidates is discussed, together with the limitations of current models. The scientific rationale of emerging therapeutic candidates is outlined in the setting of the biological mechanisms implicated in the complex pathogenesis of ARDS. Emerging therapies, currently in clinical trials, are discussed, including the pre-clinical basis for their use and the expected timeline to trial completion.

Expert opinion: We highlight the necessity of improving pre-clinical models of ARDS and the design of clinical trials for the development of novel pharmacological therapies. We reflect on the most promising emerging strategies and their potential role in ARDS management.

KEYWORDS:

• Acute respiratory distress syndrome
• acute lung injury
• biological targets
• clinical trial design

Declaration of interest

CM O’Kane reports a travel grant from AstraZeneca and that her spouse has received personal fees from consultancy for GlaxoSmithKline, SOBI, Peptinnovate, Boehringer Ingelheim, and Bayer. CM O’Kane’s institution has also received funds from grants from the Northern Ireland Health and Social Care Research and Development office for studies outside of the submitted work. DF McAuley reports fees for consultancy from GlaxoSmithKline, Bayer, Peptinnovate, and SOBI. His institution has received funds for his undertaking of bronchoscopy as part of a clinical trial funded by GlaxoSmithKline. He is also a named inventor on a patent for a pharmacotherapy for the treatment of acute respiratory distress syndrome held by his institution. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Additional information

Funding

This paper was not funded