Abstract Background Dry powder inhalers (DPIs) represent a critical advancement in pulmonary drug delivery, prized for their portability, propellant-free nature, and patient-centric design. The field is rapidly evolving through innovations in device engineering, powder formulation, and the integration of digital technologies. This systematic review investigate the recent evidence on these developments to provide a comprehensive state-of-the-art assessment. Methods A systematic literature search was conducted following PRISMA guidelines across PubMed/MEDLINE, Embase, Scopus, and Web of Science for studies published between 2013 and 2023. Eligible studies reported on novel DPI designs, formulation technologies, or smart inhaler capabilities. Data were extracted from eight included studies and critically appraised for quality and relevance. Results The review identified significant advancements across three domains. (a) Device Design: Novel breath-actuated and active power-assisted DPIs demonstrated enhanced aerosolization efficiency and reduced reliance on patient inspiratory effort. Computational Fluid Dynamics (CFD) and Discrete Element Modeling (DEM) were highlighted as crucial tools for optimizing device geometry. (b) Formulation Engineering: Particle engineering techniques, including novel carrier systems and engineered powders, improved aerodynamic properties, leading to superior lung deposition profiles and pharmacokinetics. (c) Smart Technologies: The emergence of digital inhalers with integrated sensors and microprocessors showed great potential for improving adherence, minimizing device-use errors, and enabling personalized medicine through data collection. Conclusion Recent advancements in DPI technology are multifaceted, addressing key challenges in drug delivery through innovative engineering and digitalization. While these developments promise to significantly improve therapeutic efficacy and patient outcomes, the review also notes a need for more standardized clinical studies to validate long-term benefits and facilitate widespread adoption. The future of DPI technology lies in the continued convergence of pharmaceutical science, engineering, and digital health.
Sanusi et al. (Fri,) studied this question.