Application and efficacy of the multi‐dose powder inhaler, Easyhaler^®, in children with asthma

Abstract

With powder inhalers, optimal performance is dependent on the inspiratory flow produced by the patient through the devices. The objective of this open, non-randomized study was to evaluate the suitability of a new, multidose, dry powder inhaler, the Easyhaler, for children with asthma. The peak inspiratory flow (PIF) through the Easyhaler (PIF(EH)) was measured with a pneumotachograph in 120 asthmatic children aged 4-16 yr. The bronchodilatory effect of 0.2 mg salbutamol through the Easyhaler was compared with that of 0.2 mg salbutamol through a metered dose inhaler (MDI) with a spacer, in 15 children with obstruction. The mean PIF(EH) was 56 l/min (range 22-83 l/min). The PIF(EH) correlated significantly with age, height, and absolute peak expiratory flow (PEF), but not with the level of obstruction (PEF percentage of predicted, range 45-146%). Only four children (aged 5, 6, 10, and 16 yr) had PIF(EH) values below 28 l/min, which has been shown in in vitro studies to be the threshold for effective use of the Easyhaler. In 15 children with PEF, < 85% of predicted bronchodilatory effects of 0.2 mg salbutamol through the Easyhaler and from an MDI-cum-spacer were equal. Most children aged 6-16 yr produce PIF values sufficient for the use of the Easyhaler. The gain of 0.2 mg salbutamol from the Easyhaler was equal to that from a new, unprimed, MDI with a spacer in children with asthma.

Inspiratory flows through dry powder inhaler in chronic obstructive pulmonary disease: age and gender rather than severity matters

“…The observed inspiratory flows observed in the current study (Figure 2) are well within these limits, so despite the high resistance of the inhaler, the great majority of COPD patients were able to achieve sufficient inspiratory flows through Easyhaler for optimal drug delivery to the lower airways. This finding agrees with a previous study of young children with asthma who also showed sufficient inspiratory flows through this inhaler 19. Furthermore, a study with pediatric and adult asthmatic patients has confirmed that clinical efficacy of salbutamol is maintained even at low inspiratory flow rates when using Easyhaler 20…”

The Inhalation Characteristics of Patients When They Use Different Dry Powder Inhalers

“…(7,24,25,27) When using the Diskus, similar numbers of COPD patients (25,29) and children with asthma (22) achieved inhalation flow compared with those in this study. This also applies to previous reports of inhalation flows through the Easyhaler by children with asthma (32) and COPD patients.…”

Switching patients from other inhaled corticosteroid devices to the Easyhaler&reg;: historical, matched-cohort study of real-life asthma patients

“…In experimental studies and randomized controlled clinical trials, the EH has been shown to be at least equivalent in lung deposition and/or clinical efficacy to other DPIs or pressurized metered-dose inhalers (pMDI) for a variety of asthma medications, including inhaled corticosteroids (ICS),2–10 short-acting β 2 receptor agonists (SABA),11–18 and long-acting β 2 receptor agonists (LABA) 19…”

“…First, unlike some other DPIs in common use, which require inspiratory flow rates of 45–60 L/minute for optimal drug delivery,20–23 the EH generates a consistent therapeutic dose at inspiratory flow rates as low as 28 L/minute 12,23,24. Even young children with asthma11,12 and elderly patients with chronic obstructive pulmonary disease (COPD)25 can usually manage inspiratory flow rates of at least 28 L/minute.…”