Abstract
Background: Successful delivery of inhalation medication to the lungs in COPD is affected by factors such as inspiratory flow and throat geometry. This study investigated whether such factors affect predicted lung dose after inhalation of BF.
Methods: Using a validated method to predict lung deposition for inhaled medication (Olsson et al. J Aerosol Med Pulm Drug Deliv 2013; 26:1-15), two dry-powder inhalers containing BF [Spiromax® and Turbuhaler® (TBH)] were analyzed using three different anatomical throat models and three different inhalation profiles obtained from 50 patients with COPD (Azouz et al. Eur Respir J 2013; 42:Suppl. 57, 711). Lung dose predictions were made from filter testing of dose that survived the various throat geometries at the different inhalation profiles.
Results: The overall mean predicted lung dose of BF was similar for Spiromax (111.1µg/3.0µg) compared with TBH (102.2µg/3.0µg). However, variations were seen when comparing predicted lung dose in individual scenarios. Average predicted budesonide lung dose (mean of data for all throat geometries) for weak, medium, and strong inhalation profiles were 107.9, 105.4, and 119.9 µg for Spiromax and 54.5, 102.9, and 149.1 µg for TBH, respectively. Spiromax was sensitive for variations in throat geometry. Overall, similar effects were observed with formoterol.
Conclusions: While both devices deliver a similar predicted lung dose in an average of all scenarios, TBH was sensitive for variations in inhalation profile, while Spiromax was sensitive for throat geometry. Spiromax delivered a more consistent dose of BF regardless of variations in inspiratory flow.
- © 2014 ERS