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New Virus Strain’s Transmissibility to Cause More Deaths: Study
By Corinne Gretler , December 24, 2020, 4:25 AM EST >>>>>>>
The mutated coronavirus strain that’s been spreading in the U.K. appears to be more contagious and will likely lead to higher levels of hospitalizations and deaths next year, a new study showed.
The variant is 56% more transmissible than other strains, according to the study by the Centre for Mathematical Modelling of Infectious Diseases at the London School of Hygiene and Tropical Medicine. There’s no clear evidence that it results in more or less severe disease.
https://www.bloomberg.com/news/articles/2020-12-24/new-virus-strain-s-transmissibility-to-cause-more-deaths-study
THE DAWNING OF AVIPTADIL
A vaccine works by training the immune system to recognize and combat pathogens, either viruses or bacteria. To do this, certain molecules from the pathogen must be introduced into the body to trigger an immune response. These molecules are called antigens, and they are present on all viruses and bacteria.
https://www.publichealth.org/public-awareness/understanding-vaccines/vaccines-work/
What's the Difference Between IG [Immuno Globulin] and Vaccine? IG is a substance made up of antibodies that are naturally made by the body to provide protection from certain diseases. A vaccine is a substance made up of actual viruses or bacteria that stimulate the body to make more antibodies.
https://www.verywellhealth.com/what-is-immune-globulin-1760124
The addition of VIP was associated with a significant increase in the production of IgA, whereas IgG levels were significantly reduced. Both these effects were restricted to LPMC. LDA showed that the IgA-enhancing effect was associated with an increase in the number of IgA-producing precursor cells and with variation in the regulatory phenomena involved in IgA production.
https://pubmed.ncbi.nlm.nih.gov/8119526/
Further investigation demonstrated increased intracellular cAMP concentration after VIP administration, and showed that the protective effect of VIP on concanavalin A-induced hepatitis was mediated mainly through VIP receptor 1 (VPAC(1)). These results suggest that VIP is capable of attenuating immune-mediated liver injury in vivo. This effect is associated with its downregulation of critical inflammatory mediators and its upregulation of anti-inflammatory cytokine through VPAC(1), possibly via the cAMP-dependent pathway.
https://pubmed.ncbi.nlm.nih.gov/19222997/
David Mitch, president and founder of the campaign group Patients for Affordable Drugs, echoed this sentiment when he wrote, “I sort of view Big Pharma, as an industry, as an octopus with many tentacles, and at the end of every tentacle is a wad of cash… It reaches into academic medical centers, professional organizations, patient organizations, state houses, campaigns, Congress – they’re everywhere.”
https://www.fdareview.org/2019/07/29/worried-about-big-pharma-then-reduce-the-fdas-regulatory-power/amp/
The EMA and the FDA had high concordance (91–98%) in decisions on marketing approvals. Divergence in approval decisions, type of approval, and approved indication were primarily due to differences in agencies’ conclusions about efficacy based on review of the same data or differing clinical data submitted to support the application. This high rate of concordance suggests that engagement and collaboration on regulatory science has a positive impact.
https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.1565
Yes, nurse Huffman, currently at El Paso, TX , where people are bracing for impact.
https://www.npr.org/sections/coronavirus-live-updates/2020/11/25/938850319/el-paso-issues-new-curfew-as-perfect-storm-approaches-with-arrival-of-holidays
Peer reviewed???
Once RLF-100 inhaler trial begins, will the NIH join in with a parallel Influenza trial???
https://www.cdc.gov/flu/about/season/flu-season.htm
In the United States, flu season occurs in the fall and winter. While influenza viruses circulate year-round, most of the time flu activity peaks between December and February, but activity can last as late as May.
http://www.niaid.nih.gov/clinical-trials/influenza-challenge-studies
What does the study involve?
>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Participants will be asked to make one visit to the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland, for a blood draw, medical history, and physical exam. If eligible for and interested in future studies, the participant will return to NIH and may need to stay in the inpatient unit.
Most people with an IgA deficiency don’t have any symptoms of the health problem. It’s usually found on a blood test, if it’s found at all. About 1 in 4 to 1 in 2people with selective IgA deficiency will be affected. Some people with an IgA deficiency are more likely to get frequent infections. These can include sinus, lung, and digestive infections. Some people with IgA deficiency also are more likely to have allergies, and digestive and autoimmune problems such as celiac disease or lupus.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/immunoglobulin-a-deficiency
The addition of VIP was associated with a significant increase in the production of IgA, whereas IgG levels were significantly reduced. Both these effects were restricted to LPMC. LDA showed that the IgA-enhancing effect was associated with an increase in the number of IgA-producing precursor cells and with variation in the regulatory phenomena involved in IgA production.
https://pubmed.ncbi.nlm.nih.gov/8119526/
Click on link
https://www.neurorxpharma.com/our-services/usa-based-patients/
Select “A patient in the USA, or a relative”
Protesters converge in Leipzig, Germany - Covid-19
The FDA will issue an emergency use authorization (EUA) to facilitate access to medical countermeasures (drugs, biologics, vaccines, and/or devices) that can be used to diagnose, TREAT or PREVENT a serious disease or condition in a public health emergency. RLF-100 soon???
We are heading towards a cliff! Where is RLF-100???
Raging COVID-19
https://kfoxtv.com/news/coronavirus/el-paso-moves-to-10-mobile-morgues-for-covid-19-deaths-as-judge-wants-to-extend-shutdown
What works is RLFTF, Misty Huffman knows
Thank you tigger
$RLFTF trials at El Paso, TX???
Houston Methodist Hospital was first to report recovery in a 54-year-old man who developed Covid-19 and became critical. The man had undergone a double lung transplant and later contracted Covid-19 infection. Doctors administered RLF-100 under emergency use and the patient could be weaned off ventilator in four days. “He received three infusions of RLF-100 under an FDA-approved emergency use IND (Investigational New Drug). Within 24 hours of the third infusion, substantial improvement in oxygen saturation and radiographic improvement in characteristic COVID-19 pneumonitis was noted. He was discharged from intensive care at that point and returned home at 1 week on room air,” a multi-author article by doctors stated. This article is however not yet peer reviewed~ Texas Covid-19 dot com
https://www.texasmonthly.com/news/el-paso-covid-19-spike-juarez-border/
Dr. Jonathan Javitt announces MERGER and NEW PROJECTS COMING...
We're at an inflection point in the company where we've signed a term sheet to merge with a NYSE company be publicly listed in the next two quarters. We currently have 50 million dollars in assets. So we're funded through data. We're raising an additional 50 million dollars prior to that listing so that we have the ability to open some new projects that we think will be exciting to the marketplace and to our investors. The funding for the remaining of the SamiAir development is contractually committed by Relief Therapeutics. A Suisse publicly listed company. And we have one hundred million dollar post listing commitment for funding from the GEM Global Markets Fund. So numerous banks are in the process of vetting us. We think that there's strong interest in covering us. And we look forward to seeing you in the marketplace or before.
https://sonix.ai/r/xtrz7PUXeMjvyvbr48n12Ucj/share
MERGER ACQUISITION???
When one public company buys another, stockholders in the company being acquired will generally be compensated for their shares. This can be in the form of cash or in the form of stock in the company doing the buying. Either way, the stock of the company being bought will usually cease to exist.
https://finance.zacks.com/happens-stocks-one-public-company-buys-another-8471.html
REVERSE MERGER???
A reverse merger happens when a publicly trading company merges with a private company and the private company survives, occupying and operating in the publicly traded company's legal shell. The private company takes over controlling ownership of the stock of the public company and management of the company, usually changing the company's name to its own and changing the stock symbol. It is not necessary for both companies to be in the same business; in fact, usually they are in very different businesses.
https://finance.zacks.com/reverse-merger-mean-stocks-1096.html
KODAK MOMENTS COMING???
Javitt knows a lot about public health policy because one of his professors chided him when he heard that the young medical student was going to India to help cure patients with glaucoma.
“All you’ll be doing is helping a blind beggar see,” the thoughtless man told Javitt.
Enraged, Javitt conducted a study that proved that restoring eyesight to Indian patients with the eye disease increased their family earnings by 1,500%. The patient, now able to see, was able to work – and the pressure on his family to care for him was lifted, helping the entire family advance in life.
https://m.jpost.com/health-science/neurorx-on-the-cusp-of-releasing-a-life-saving-covid-19-treatment-644470/amp
Researchers have recently reported that injecting a neuropeptide called vasoactive intestinal peptide (VIP) into the eyes of mice enhanced the survival rate of the corneal transplant. The study also listed other benefits of VIP, including accelerated endothelial wound closure, protection of corneal endothelial cells (CEnCs) and a notable improvement in the clarity of the corneal transplant.
CEnCs are responsible for keeping the corneal graft transparent, and VIP helps protect these cells from certain cell deaths. Researchers are also looking into the benefits VIP can provide to the donated corneas. They have reason to believe that vasoactive intestinal peptides can be used to preserve the endothelial cells in these donated grafts, making them more likely to survive the transplant.
https://www.myopiainstitute.com/eye-care/improving-corneal-transplant-survival-using-new-techniques/amp/
The global myopia and presbyopia treatment market size valued at USD 15.5 billion in 2018 and is expected to grow at a compound annual growth rate (CAGR) of 7.7% from 2019 to 2026.
https://www.grandviewresearch.com/industry-analysis/myopia-presbyopia-treatment-market
Dr. Javitt continued: “The SARS-CoV-2 attacks the body by entering the small population of Alveolar Type II cells in the lung, almost like hitting the needle in the haystack.1 Without Type II cells, the lung cannot transmit oxygen, which is exactly what happens in COVID-19. We know, from 50 years of scientific research that VIP binds specifically to the Type II cell and protects that cell against cytokines (inflammatory molecules) and a wide array of toxic and infectious injuries.2”
https://investorshub.advfn.com/boards/read_msg.aspx?message_id=157616447
Small-cell lung carcinoma (SCLC) is an aggressive, rapidly growing and metastasizing, and highly fatal neoplasm. We report that vasoactive intestinal peptide inhibits the proliferation of SCLC cells in culture and dramatically suppresses the growth of SCLC tumor-cell implants in athymic nude mice.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC24380/
The global market value for Non-Small Cell Lung Cancer (NSCLC) treatment will increase from $6.9 billion in 2014 to $10.9 billion by 2021, representing a Compound Annual Growth Rate (CAGR) of 8.5%, says business intelligence provider GBI Research.
https://drug-dev.com/global-non-small-cell-lung-cancer-treatment-market-value-to-approach-11-billion/
•Multinational Randomized Clinical Trials (MRCTs) are challenging
•But, despite the challenge, the need to conduct clinical research internationally is stronger than ever
•The increasing shift from expert opinion towards evidence-based medicine enhances the importance of MRCTs
•In addition, the demand of Health Authorities (HAs) for high quality data is also increasing,
https://www.dellmed.com/
• From October 2007 to Sept 2008, clinical trials for medical products were conducted at nearly 6,500 foreign sites
– Western Europe accounted for 60% of total non-US sites
– The other 40% was nearly evenly divided: • Eastern Europe: 11%
• Asia/Pacific: 10%
• Non-U.S. North America: 8% • Central/South America: 8%
U.S. Department of Health and Human Services. 2010. Challenges to FDA’s Ability to Monitor and Inspect Foreign Clinical Trials. Retrieved June 16, 2011, from http://oig.hhs
https://www.fda.gov/media/87406/download
Forget that, let Watson handle it!
Ok, so a more grounded version of the fairy tale would be three weeks after they stop or first week of December...?
Boonjug, I share your enthusiasm, to da moon and beyond! I wonder if November 2 is the first rocket launch. We’ll have to wait and see.
VIP AS AN IDEAL BETA-CELL PROTECTION/REPLICATION AGENT
Type 2 diabetes (T2D) is characterized by chronic insulin resistance and a progressive decline in beta-cell function. Although rigorous glucose control can reduce morbidity and mortality associated with diabetes, achieving optimal long-term glycemic control remains to be accomplished in many diabetic patients. As beta-cell mass and function inevitably decline in T2D, exogenous insulin administration is almost unavoidable as a final outcome despite the use of oral antihyperglycemic agents in many diabetic patients. Pancreatic islet cell death, but not the defect in new islet formation or beta-cell replication, has been blamed for the decrease in beta-cell mass observed in T2D patients. Thus, therapeutic approaches designed to protect islet cells from apoptosis could significantly improve the management of T2D, because of its potential to reverse diabetes not just ameliorate glycemia. Therefore, an ideal beta-cell-preserving agent is expected to protect beta cells from apoptosis and stimulate postprandial insulin secretion along with increasing beta-cell replication and/or islet neogenesis. One such potential agent, the islet endocrine neuropeptide vasoactive intestinal peptide (VIP) strongly stimulates postprandial insulin secretion. Because of its broad spectrum of biological functions such as acting as a potent anti-inflammatory factor through suppression of Th1 immune response, and induction of immune tolerance via regulatory T cells, VIP has emerged as a promising therapeutic agent for the treatment of many autoimmune diseases including diabetes.
https://jme.bioscientifica.com/view/journals/jme/49/3/R157.xml
Diabetes Drugs Market Size Worth Around US$ 60.2 Bn By 2026
https://www.globenewswire.com/news-release/2020/01/31/1978167/0/en/Diabetes-Drugs-Market-Size-Worth-Around-US-60-2-Bn-By-2026.html
Javitt knows a lot about public health policy because one of his professors chided him when he heard that the young medical student was going to India to help cure patients with glaucoma.
“All you’ll be doing is helping a blind beggar see,” the thoughtless man told Javitt. >>>>>>>>>>>>>>>
Enraged, Javitt conducted a study that proved that restoring eyesight to Indian patients with the eye disease increased their family earnings by 1,500%. The patient, now able to see, was able to work – and the pressure on his family to care for him was lifted, helping the entire family advance in life.
https://www.jpost.com/health-science/neurorx-on-the-cusp-of-releasing-a-life-saving-covid-19-treatment-644470
Multiple sclerosis (MS) is a disabling inflammatory, autoimmune demyelinating disease of the central nervous system (CNS). Despite intensive investigation, the mechanisms of disease pathogenesis remain unclear, and curative therapies are unavailable for MS. The current study describes a new possible strategy for the treatment of MS, based on the administration of the vasoactive intestinal peptide (VIP). Treatment with VIP significantly reduced incidence and severity of experimental autoimmune encephalomyelitis (EAE), an MS-related rodent model. VIP suppressed EAE neuropathology by reducing CNS inflammation and by selective blocking encephalitogenic T-cell reactivity, emerging as an attractive candidate for the treatment of human MS.
https://pubmed.ncbi.nlm.nih.gov/16888178/
Multiple Sclerosis Therapeutics Market To Reach USD 25.91 Billion By 2026 | Reports And Data
https://www.globenewswire.com/news-release/2019/12/03/1955908/0/en/Multiple-Sclerosis-Therapeutics-Market-To-Reach-USD-25-91-Billion-By-2026-Reports-And-Data.html
With an estimated lifetime cost per MS patient of over $4 million, MS is the second-ranked chronic condition (behind congestive heart failure) in direct all-cause medical costs. For the U.S., the total estimated cost of MS is $28 billion per year.
https://www.optum.com/business/resources/library/ms-cost-drivers.html
As Uncle Gee Gee commented, “...they may have struck a deal...”, another one!!!
NeuroRX and Relief Therapeutics SA could merge, possible???
https://www.globenewswire.com/news-release/2019/09/16/1916030/0/en/Antipsychotic-Drugs-Market-Size-to-Reach-USD-20-539-5-Million-by-2026-Schizophrenia-Segment-to-Witness-Rapid-Growth-says-Fortune-Business-Insights.html
NeuroRX knows a thing or two about neurological disorders, yes??? >>>>>>>>>>>>>>>>>>>>>>
There is mounting evidence that VIP expression and signaling is altered in numerous neurological disorders, and it is becoming apparent that VIP and its receptors could be therapeutic loci for the treatment of several pathological conditions of the central nervous system. In this review, we describe the pathology of several major neurological disorders and discuss the potential pharmacotherapeutic role of VIP and its receptors for the treatment of disorders such as Alzheimer’s disease, Parkinson’s disease, and Autism Spectrum Disorders.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2967653/
As per the report, the global Alzheimer's therapeutics market is expected to grow from USD 4.36 Billion in 2018 to USD 8.19 Billion by 2026, at a CAGR of 8.20% during the forecast period 2019-2026.
https://www.pharmiweb.com/press-release/2020-07-13/global-alzheimer-s-therapeutics-market-is-expected-to-grow-at-a-cagr-of-820-during-the-forecast-pe
NOTEWORTHY POTENTIAL Vasoactive intestinal polypeptide (VIP) is an inhibitory non-adrenergic, non-cholinergic transmitter, which mediate in the relaxation of sphincters of the gastrointestinal tract. The aim of this study was to determine whether there is a change in the pattern of innervation and tissue content of VIP in the rat gastroduodenum after the onset of streptozotocin (STZ)-induced diabetes mellitus. Diabetes was induced by a single intraperitoneal injection of STZ (60 mg Kg(-1)). Four weeks after the induction of diabetes mellitus, the rats were anaethetised and the pancreata were removed for further processing. VIP was localized and measured in normal and diabetic rat gastroduodenal tissues by immunohistochemistry and radioimmunoassay, respectively. VIP immunoreactivity was stronger in the ganglion cells of the submucosal and myenteric plexuses of the gastric antrum and duodenum of normal rats (n = 6) when compared to that of diabetic rats (n = 6). Moreover, the number of VIP-positive neurons was significantly lower in the gastrointestinal tract of diabetic rats compared to normal. The VIP content of the gastric antrum and duodenum of diabetic rat was significantly lower (p< 0.05) than that of normal rat. In contrast to the lower tissue levels of VIP in the gastroduodenal segment of diabetic rats, the plasma level of VIP was significantly higher (p< 0.04) in diabetic rat compared to normal. The plasma level of VIP in normal rats was comparable to that measured in normal human beings. A low tissue level of VIP in the gastroduodenal tract of diabetic rat may contribute in part to the abnormal gut motility observed in diabetic patients.
https://pubmed.ncbi.nlm.nih.gov/11880929/
Global Diabetes Therapeutics Market was valued at $66,993 million in 2016, and is estimated to reach $186,842 million by 2023, growing at a CAGR of 16.0% from 2017 to 2023.
https://www.alliedmarketresearch.com/diabetes-therapeutics-market
The estimated total economic cost of diagnosed diabetes in 2017 is $327 billion, a 26% increase from our previous estimate of $245 billion (in 2012 dollars). This estimate highlights the substantial burden that diabetes imposes on society.
https://www.diabetes.org/resources/statistics/cost-diabetes
It is hard to say he meant Aviptadil as “certain drug”. It would not be useful either. If the “certain drug” makes you feel twenty years younger I would be very biased and say it’s a VIP drug, IMHO!! >>>>>>>
If the president got experimental drugs, that means he was getting the best possible medical care. Wrong again. The majority of drugs in development — up to 90% of them — fail to come to market either because they don’t work or because they cause unacceptable side effects. The president might have gotten compounds that could help him; he might also have gotten compounds that could hurt him, especially because they were administered in untested combinations. https://www.statnews.com/2020/10/08/compassionate-use-covid-19-drug-means-and-doesnt-mean/
So many possibilities with VIP!!! Also, I thought your Goog drive resource doc was available/linked at the top of the $RLFTF board. I’m sorry to read some people out there are trying to ruin it. I think it is an excellent resource!!
VIP FOR AUTOIMMUNITY
AMAZING POTENTIAL The global market value for Non-Small Cell Lung Cancer (NSCLC) treatment will increase from $6.9 billion in 2014 to $10.9 billion by 2021, representing a Compound Annual Growth Rate (CAGR) of 8.5%, says business intelligence provider GBI Research.
https://drug-dev.com/global-non-small-cell-lung-cancer-treatment-market-value-to-approach-11-billion/
CAN WE SAY “WONDER DRUG”???
Autoantibodies capable of binding the immunoregulatory neuropeptide vasoactive intestinal peptide (VIP) were detected in the sera of a mouse strain prone to autoimmune disease due to the lpr mutation (MRL/lpr). The autoantibodies were not present in control wildtype MRL/lpr mice, but they were readily detected in humans without autoimmune disease. The binding was due to low affinity VIP recognition. Increased VIP binding activity was evident in patients with systemic lupus erythematosus but not systemic sclerosis, Sjögren's syndrome (SS), rheumatoid arthritis or autoimmune thyroiditis. Recombinant VIP binding Fv clones (fragment variable; the variable domains of the light and heavy chains antibody subunits joined with a peptide linker) were isolated from a phage display library prepared from lupus patients. One Fv clone displaying VIP-selective binding and several clones displaying cross-reactivity with unrelated peptides were identified. Replacement mutations in the VIP-selective clone were preferentially localized in the regions known to make contacts with the antigen, i.e. the complementarity determining regions, suggesting that the selective binding activity is due to immunological maturation of the antibodies. Frequent occurrences of autoantibody responses to VIP indicate that immunological tolerance to this neuropeptide can be readily broken. The depletion of VIP by specific antibodies in autoimmune disease may interfere with VIP regulation of T cells and inflammatory cells and result in further amplification of autoreactive immunological responses.
https://pubmed.ncbi.nlm.nih.gov/12535706/
The Global Autoimmune Disease Therapeutics Market size is expected to reach $149.4 billion by 2025, rising at a market growth of 4.34% CAGR during the forecast period.
https://www.prnewswire.com/news-releases/the-global-autoimmune-disease-therapeutics-market-size-is-expected-to-reach-149-4-billion-by-2025--rising-at-a-market-growth-of-4-34-cagr-during-the-forecast-period-300902336.html
Ah, Steppenwolf!
Mold illness is actually a subcategory of a broader condition that Shoemaker calls chronic inflammatory response syndrome (CIRS). CIRS is identified as “an acute and chronic, systemic inflammatory response syndrome acquired following exposure to the interior environment of a water-damaged building with resident toxigenic organisms, including, but not limited to fungi, bacteria, actinomycetes and mycobacteria as well as inflammagens such as endotoxins, beta glucans, hemolysins, proteinases, mannans and possibly spirocyclic drimanes; as well as volatile organic compounds,” according to Shoemaker’s website, SurvivingMold.
https://www.prohealth.com/library/overview-lyme-disease-mold-illness-91639
The global systemic inflammatory response syndrome treatment market was valued at ~US$ 9.3 Bn in the year 2018, and is expected to expand at a CAGR of ~8% from 2019 to 2027, to reach a value of ~US$ 17.8 Bn by 2027.
https://www.transparencymarketresearch.com/systemic-inflammatory-response-syndrome-treatment-market.html
Will VIP become our good friend?
The post is based on the assumption RLF-100 gets approved for COVID-19/ARDS?? What will be the FDA pathway to repurpose RLF-100? Is the pathway 505(b)(2)? If yes, will it be faster than the current fast tracked IND?? Will COPD and Asthma be next?? Will RFL-100 be the next standard of care for several indications??
QUOTE: The thing to remember is the market for this may be much larger than COVID. If it works as well as it appears it could become the standard of care for anyone with an ARDS like disease, from any cause. That’s a lot of lives saved. ~BSfreeMD
I thought it would be better than politics
Can you explain why my post has not been deleted??? Go figure!
A March of ducklings on a pathway?? >>>>>>>>>>>>>>>>>>>>
The 505(b)(2) functions essentially as a middle path for drugs that are not entirely new, but are not generic forms of existing drugs, either. Created in 1984 by legislation termed the Hatch-Waxman Amendments, this pathway "is intended to streamline the development and U.S. Food and Drug Administration (FDA) approval of pharmaceutical products that incorporate already-approved pharmacological agents." It allows applicants to provide studies conducted by other entities for other drugs with the same active ingredients, unlike 505(b)(1) applicants, who must provide research conducted specifically for the drug in question. This allows for several benefits, including a decreased risk, given that the active ingredients have already been approved; decreased costs, given that fewer studies need to be conducted; and a potential three, five, or seven year exclusivity period in which the drug will face no competition.
https://askwonder.com/research/fda-s-505-b-2-6xtw0i30s
The Global Asthma and COPD Drugs market is expected to reach $50,359 million by 2022, growing at a CAGR of 3.7% from 2016 to 2022. Asthma is a chronic respiratory disease blocking the airways of lung because of inflammation, mucus production, tighten of muscles. Chronic Obstructive Pulmonary Disease(COPD) is caused by obstruction in the airways causing difficulty in breathing, with the primary cause as tobacco smoking.
https://www.alliedmarketresearch.com/asthma-COPD-drug-market