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

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

• 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

Conclusion

• The delivery of medication from the AEROECLIPSE* II BAN* to the lungs was not affected by the incorporation of the Aerobika* OPEP device. Aerosol deposition within the lung was unaltered by the addition of the OPEP device as evidenced by the near identical percentage of the dose being deposited in both the peripheral and central airways.
• BAN+OPEP therapy could offer the clinician the opportunity for combined treatment thereby reducing the time needed for the patient to take both nebulizer and OPEP treatments separately.

The FRI deposition profiles highlighted significant differences between the VHCs on test, with intrathoracic delivery for the AeroChamber Plus* Flow-Vu* VHC system being almost double that of the other two VHC systems and being similar to the MDI alone with perfect coordination

Medications to manage care of bronchiectasis and NTM patients are often delivered via a nebulizer. This study compares a number of different OPEP/Nebulizer combinations using salbutamol as the modelled medication.

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.

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.

Conclusions:

From a UK perspective, BUD/F delivered via an MDI + VHC offers an economic benefit for the treatment of patients with mild asthma. Further analysis is required to determine if there would be any quality-adjusted life-year (QALY) effects based on the chosen intervention.

This study aims to determine if a portable VHC could improve MART therapy effectiveness outside of the home. 

Depending on the pMDI/spacer system chosen the delivery of medication can vary significantly and as a result will have implications on the potential carbon footprint.

In this case, the use of the AeroChamber Plus* Flow-Vu* VHC could potentially reduce the carbon footprint by three fold compared to the alternative spacers.

By maximizing the amount of each puff reaching the lungs the patient is likely to be able to get relief sooner and reduce the amount of puffs needed.

Patient use & evaluations of Aerobika* device across 23 UK Centres

RESULT: Improved CAT scores, 92% patients continuing Tx, 87% HCP (very) happy.

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

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

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

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].

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.

Presented at the British Thoracic Society December 2018.

Having a child with asthma can be stressful for parents, especially for financially strapped ones struggling to pay for an arsenal of puffers and pills for their child’s treatment. Because of this, those healthcare professionals who recommend spacer chambers may suggest one of many lower-cost versions that are available on the market today. But focusing only on cost may be putting a child’s health at risk.

Conclusions:

• The most efficient and effective delivery method remains that recommended in the device IFU (one actuation inhaled at a time, as well inhalation as soon as possible after actuation)
• However, this laboratory-based study has indicated that a modified common-canister protocol with an anti-static VHC as the aerosol transfer vehicle has the potential to be a viable ‘off-label’ proposition in hospital situations where there is an urgent need to conserve pMDI medication as well as avoid cross-contamination from pathogenic viruses or bacteria

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