Summary:

Presented at DDL 2017 in Edinburgh

• Valved holding chambers are widely prescribed to assist patients receiving inhaled medications by avoiding losses caused by imperfect coordination of inhalation and actuation and also to reduce oropharyngeal deposition.
• Regardless of whether using a solution based formulation (like Qvar) or a suspension formulation (Flovent), the use of a valved holding chamber reduced the amount of medication deposited in the mouth (oropharynx) and increased the potential for lung delivery
• This study can be used to help demonstrate the value of using a valved holding chamber for both solution and suspension formulated metered dose inhalers and for all patient populations, including adults

• The FRI deposition profiles highlight that the MDI/AeroChamber Plus* Flow-Vu* VHC delivered a significantly greater percentage of drug to the lung region than either of the two DPIs, irrespective of flow rate.
• This was reflected in much higher modelled oropharyngeal deposition for the two DPIs.
• The influence of inhalation flow profile was significant for one of the DPIs.

RDD 2020 - E-Poster Presentation

COPD is a chronic and progressive disease that requires regular self-administration of inhaled medications. However, as the disease progresses, reduced respiratory muscle strength may prevent patients from generating sufficient inspiratory effort to effectively use dry-powder inhalers (DPIs) [1, 2]. In contrast, patients can inhale slowly or breathe tidally from a pMDI with VHC without the need to coordinate with inhaler actuation [3].

Lab study evaluating medication delivery MDI alone vs new portable spacer  

RESULT: Portable spacer provides optimum delivery without need for inhalation coordination.

Short-acting beta2 agonist (SABA) monotherapy is typically required to provide as needed short term relief of bronchoconstriction. The salbutamol EasyHaler† DPI has recently become available in the UK as an alternative to delivery by pressurized metered-dose inhaler. Our study evaluated delivery from this DPI at different inhalation flow rates.

PRESENTED AT VIRTUAL ATS 2020

• Evaluations of inhaler use have demonstrated that mishandling of MDIs is commonplace.
• One of the most common errors is the failure to coordinate inhalation with actuation of the inhaler
• One of the reasons why VHCs are often prescribed, is to reduce the severity of this error
• This Functional Respiratory Imaging (FRI) based study assessed the likely severity of a short inhalation delay (from actuation) with an MDI alone and how it contrasted to the use with a VHC

Conclusions:

• The widely differing inspiratory flow profiles from Turbuhaler† DPI contributed to greater variability in delivered dose to the carina. 
• MDI delivery via the AeroChamber Plus* Flow-Vu* VHC resulted in significantly increased mass to the carinal region irrespective of inhalation maneuver as well as reduced oropharyngeal deposited mass which in vivo is likely to result in reduced throat irritation or thrush in the mouth and throat.

Conclusions:

• The DPI results suggest that inhalation breathing profiles can have an appreciable impact upon aerosol delivery, with one participant having much less predicted medication as fine particles
• In contrast, although the inhalation profiles across all participants were also divergent when asked to inhale from the pMDI + VHC, either tidal breathing or by a slow, deep inhalation, all volunteers would have received a relatively consistent amount of medication.
• It also appears that the pMDI + VHC platform delivers a larger FPM<5.0 µm for both APIs and a consequently smaller coarse particle mass. However, it is recognized that more investigation is warranted with a larger number of volunteers and with other passive DPIs having different resistances

This study was presented at the Drug Delivery to the Lungs, 2022.

Positioning of the tongue during inhaler medication delivery is something that is not thought about by either users or caregivers.

This study was presented at the Drug Delivery to the Lungs Conference, 2022.

Conclusions:

COPD/chronic bronchitis patients given an Aerobika* OPEP device compared to an alternative OPEP device had delayed time to re-admission. This supports use of the Aerobika* OPEP device as an add-on to usual care post-exacerbation and highlights differences in OPEP device effectiveness.

Does Spacer/Adapter Device Choice Affect Delivery of a Pressurized Metered Dose Inhaler (pMDI) through a Humidified Circuit to a Simulated Patient on Mecha

• Results from this study demonstrate a reduction in the proportion of patients requiring COPD/chronic bronchitis related readmission within 30 days and 12 months of the Aerobika^® OPEP device therapy initiation compared to an alternative OPEP device.
• This further supports the use of the Aerobika^® OPEP device as an add-on to usual care to manage COPD/chronic bronchitis patients post-exacerbation and highlights that not all OPEP devices are the same in terms of 30-day and 12-month readmissions

As current MDIs contain hydrofluorocarbon propellants, it would be beneficial to find ways to reduce carbon emissions without compromising patient safety.

This lab study investigated a way to optimize the modelled lung dose per actuation while at the same time minimizing the carbon emissions from the MDI

Medikro to distribute Aerobika* OPEP Devices to patients in Finland and Sweden.