Review of therapeutically equivalent alternatives to short acting beta 2 adrenoceptor agonists delivered via chlorofluorocarbon-containing inhalers

Hughes, Dyfrig; Woodcock, Ashley; Walley, Thomas

doi:10.1136/thx.54.12.1087

Cited by 15 publications

(9 citation statements)

References 38 publications

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“…For the delivery of inhaled steroids in stable asthma in children aged 5-12 years, pMDI is as effective as Clickhaler, 359,360 and Pulvinal is as effective as Diskhaler. 361 No signiÞ cant clinical difference was found between pMDI and Turbohaler at half the dose for the same drug (budesonide).…”

Section: Inhaled Steroids For Stable Asthmamentioning

confidence: 99%

British Guideline on the Management of Asthma

Douglas

Higgins

Barnes

et al. 2008

Thorax

641

120

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Section: Inhaled Steroids For Stable Asthmamentioning

confidence: 99%

British Guideline on the Management of Asthma

Douglas

Higgins

Barnes

et al. 2008

Thorax

641

120

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“…In properly designed equivalence studies, the null hypothesis is not equivalence but inequivalence. Rejecting this hypothesis leads to the proper interpretation of both treatments being equivalent [68]. Another flaw, especially with bronchodilators, is that the clinical effects are often measured using doses on the plateau of the dose–response curve.…”

Section: Bioequivalence Of Inhaled Medicationsmentioning

confidence: 99%

Pulmonary drug delivery. Part II: The role of inhalant delivery devices and drug formulations in therapeutic effectiveness of aerosolized medications

Labiris

Dolovich

2003

Brit J Clinical Pharma

359

218

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Research in the area of pulmonary drug delivery has gathered momentum in the last several years, with increased interest in using the lung as a means of delivering drugs systemically. Advances in device technology have led to the development of more efficient delivery systems capable of delivering larger doses and finer particles into the lung. As more efficient pulmonary delivery devices and sophisticated formulations become available, physicians and health professionals will have a choice of a wide variety of device and formulation combinations that will target specific cells or regions of the lung, avoid the lung's clearance mechanisms and be retained within the lung for longer periods. It is now recognized that it is not enough just to have inhalation therapy available for prescribing; physicians and other healthcare providers need a basic understanding of aerosol science, inhaled formulations, delivery devices, and bioequivalence of products to prescribe these therapies optimally.

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“…Furthermore, many MDIs still contain chlorofluorocarbons (CFCs), which have atmospheric ozone-depleting effects (4). They require a high level of patient coordination.…”

Section: Introductionmentioning

confidence: 99%

Correct Use of Three Powder Inhalers: Comparison Between Diskus, Turbuhaler, and Easyhaler

Rönmark¹,

Jõgi²,

Lindqvist³

et al. 2005

LJAS

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A Phase IV, 4-week, open, randomized multicenter parallel group trial compared correct use and acceptability of Diskus, Turbuhaler, and Easyhaler powder inhalers among 326 inhaler naive asthmatics/symptomatics. The subjects were asked to read the instruction leaflet before taking one dose at the first visit. The correct use was evaluated when the subject took the dose. After that, the subjects were instructed in correct use. The use of the devices was also videotaped at every visit, and independent referees judged correct use. Acceptability was evaluated by a questionnaire. At the first visit, the proportions of subjects who used the devices correctly were as follows: Easyhaler, 45%; Diskus, 43%; and Turbuhaler, 51%. The corresponding figures at the last visit were 84%, 89%, and 81%. The differences at any visit were not statistically significant. Acceptability was greater for Easyhaler and Diskus for three of eight items throughout the study, all pertaining to receiving the powder from the device and control of the inhalation of the powder. Patient education in the use of devices is important, because only half of the subjects used the devices correctly, and still after 4 weeks 10-20% could not use the devices satisfactorily, regardless of which device.

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Review of therapeutically equivalent alternatives to short acting beta 2 adrenoceptor agonists delivered via chlorofluorocarbon-containing inhalers

Cited by 15 publications

References 38 publications

British Guideline on the Management of Asthma

British Guideline on the Management of Asthma

Pulmonary drug delivery. Part II: The role of inhalant delivery devices and drug formulations in therapeutic effectiveness of aerosolized medications

Correct Use of Three Powder Inhalers: Comparison Between Diskus, Turbuhaler, and Easyhaler

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