Patients with asthma or chronic obstructive pulmonary disease (COPD) can attain inspiratory flows via use of the Easyhaler® dry powder inhaler (DPI) that are sufficient for its effective utilization, according to findings published in the Journal of Thoracic Disease. Researchers performed a pooled analysis of 2 multicenter, crossover, randomized controlled, open-label studies (ClinicalTrials.gov Identifiers: NCT01424137 and NCT00984906) that were conducted in Estonia, Finland, and the United Kingdom, with all of the study procedures carried out at a single visit.
Investigators sought to characterize inspiratory flow parameters across the Easyhaler, Seretide Diskus, and Symbicort Turbuhaler inhalers among patients with asthma and/or COPD of varying severity. The primary objective of the original studies was to determine peak inspiratory flow (PIF) rate and volume parameters across the Easyhaler, Diskus, and Turbuhaler in patients with asthma (including children, adolescents, and adults) and/or COPD. In the current analysis, the primary endpoint was the PIF rate through the Easyhaler.
A total of 397 patients were included in the intent-to-treat population, with 383 individuals included in the per-protocol population. Mean PIF values through the Easyhaler in patients with asthma 6 to 17 years of age, and those with asthma 8 years or older, and those with COPD were similar: 61.4±11.5 L/min, 69.7±13.5 L/min, and 61.9±13.2 L/min, respectively. These flow rates corresponded to drops in pressure of 5.05±1.80 kPa, 6.52±2.34 kPa, and 5.19±2.07 kPa, respectively.
In all of the subgroups, females had lower PIF rates compared with males: 60.4±11.2 L/min vs 62.2±11.7 L/min, respectively, in those aged 6 to 17 years with asthma; 67.0±12.8 L/min vs 75.5±13.3 L/min, respectively, in those aged 18 years or older with asthma; and 57.6±11.9 L/min vs 65.7±13.2 L/min, respectively, in patients with COPD.
Overall, 99.2% (380 of 383) of individuals in the per protocol population were able to generate a PIF rate through the Easyhaler of at least 30 L/min — a rate that is required for consistent dose delivery from the DPI. A moderate direct association was reported between age and PIF in the younger patients (6-17 years of age) with asthma, which was inverse and less obvious among patients aged 18 years or older with asthma and/or in those with COPD.
Additionally, height and weight were moderately associated with PIF. Moreover, stronger associations with PIF were seen for some lung function parameters, especially native PIF and forced expiratory vital capacity.
The researchers concluded that regardless of age or severity of airway obstruction, more than 99% of individuals with asthma and/or COPD demonstrated the ability to inhale through the Easyhaler with an adequate PIF rate.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Malmberg LP, Pelkonen AS, Vartiainen V, Vahteristo M, Lähelmä S, Jõgi R. Patients with asthma or chronic obstructive pulmonary disease (COPD) can generate sufficient inspiratory flows via Easyhaler® dry powder inhaler: a pooled analysis of two randomized controlled trials. J Thorac Dis. 2021;13(2):621-631. doi: 10.21037/jtd-20-2112