Introduction: Proper device selection is crucial for the clinical results of inhalation therapy. However, none of the available devices fully conforms to the requirements for delivering drug with increased patient adherence, and we are still looking for the ideal inhaler. For this reason, there are several ongoing technical innovations to improve inhaler devices.Areas covered: Progress in pulmonary drug delivery device technology is examined, focusing on innovations in pressurized metered dose inhalers, dry powder inhalers, nebulizers, and soft mist inhalers.Expert opinion: Both formulation improvements and new device technologies have been developed over the last couple of decades through an improved understanding of the mechanisms of aerosolization and lung deposition. Digital health is offering the potential to produce inhalers with a wider range of monitoring capabilities, but further studies are needed, in particular as regards the analysis of cost-effectiveness. Furthermore, there are still substantial issues that must be overcome in order to continually innovate and improve targeted inhaled drug delivery to the lungs. In any case, there are other potential therapeutic possibilities for COPD in development that may be administered by inhalation, whose clinical use requires advances and improvements in the devices used for administration.
Keywords: COPD; add-on spacer devices; breath-actuated pMDI; dry powder inhaler; nebulizers; pressurized metered-dose inhaler; soft mist inhaler; technological innovations.