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Published in: Pulmonary Therapy 1/2017

Open Access 01-06-2017 | Original Research

Budesonide/Formoterol Easyhaler®: Performance Under Simulated Real-Life Conditions

Authors: Jussi Haikarainen, Olof Selroos, Tero Löytänä, Sirpa Metsärinne, Anita Happonen, Paula Rytilä

Published in: Pulmonary Therapy | Issue 1/2017

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Abstract

Introduction

We compared in vitro drug delivery characteristics of two budesonide/formoterol dry powder inhalers, the Bufomix Easyhaler® and the budesonide/formoterol Turbuhaler®, at different patient air flow rates, and to test dose delivery from the Easyhaler in stressed conditions exposed to moisture, dropping, vibration and freezing/thawing.

Methods

A total of 36 inhalers from two batches of both products (160/4.5 µg strength) were used when comparing the effect of flow rate; six inhalers for each of the three flow rates for uniformity of delivered dose (DD), fine particle dose (FPD), mass median aerodynamic diameter (MMAD) and geometric standard deviation (GSD). Consistency of DD, FPD, MMAD and GSD were determined for each inhaler at three different flow rates: 10th, 50th and 90th percentile air flows. Dosing properties as a function of inhaler life were tested. The effects of moisture, dropping, vibration and freezing/thawing on DD and FPD were tested with two to four inhalers per test using all three strengths of Easyhaler: 80/4.5, 160/4.5 and 320/9 µg.

Results

The Easyhaler, 160/4.5 µg, showed statistically significantly better dose consistency (expressed as percentage of labelled dose) at all three inhalation flows compared with the Turbuhaler, 160/4.5 µg, (p < 0.001 for three flow rates). Exposure to moisture, dropping, vibration and freezing/thawing did not affect DD or FDP. These results were similar to all three tested Easyhaler strengths.

Conclusion

In vitro performance of the Easyhaler indicates reliable dosing. Dose consistency was superior compared with the Turbuhaler at all tested flow rates. Environmental moisture, dropping, vibration and freezing/thawing did not affect the performance.

Funding

Orion Corporation Orion Pharma.
Literature
1.
go back to reference Mapel DW, Roberts MH. Management of asthma and chronic obstructive pulmonary disease with combination inhaled corticosteroids and long-acting β-agonists: a review of comparative effectiveness research. Drugs. 2014;74:737–55.CrossRefPubMedPubMedCentral Mapel DW, Roberts MH. Management of asthma and chronic obstructive pulmonary disease with combination inhaled corticosteroids and long-acting β-agonists: a review of comparative effectiveness research. Drugs. 2014;74:737–55.CrossRefPubMedPubMedCentral
3.
go back to reference Malmberg LP, Everard ML, Haikarainen J, Lähelmä S. Evaluation of in vitro and in vivo flow rate dependency of budesonide/formoterol Easyhaler®. J Aerosol Med Pulm Drug Deliv. 2014;5:329–40.CrossRef Malmberg LP, Everard ML, Haikarainen J, Lähelmä S. Evaluation of in vitro and in vivo flow rate dependency of budesonide/formoterol Easyhaler®. J Aerosol Med Pulm Drug Deliv. 2014;5:329–40.CrossRef
4.
go back to reference Lähelmä S, Sairanen U, Haikarainen J, Korhonen J, Vahteristo M, Fuhr R. Equivalent lung dose and systemic exposure of budesonide/formoterol combination via Easyhaler and Turbuhaler. J Aerosol Med Pulm Drug Deliv. 2015;28:462–73.CrossRefPubMedPubMedCentral Lähelmä S, Sairanen U, Haikarainen J, Korhonen J, Vahteristo M, Fuhr R. Equivalent lung dose and systemic exposure of budesonide/formoterol combination via Easyhaler and Turbuhaler. J Aerosol Med Pulm Drug Deliv. 2015;28:462–73.CrossRefPubMedPubMedCentral
5.
go back to reference Laube BL, Janssens HM, Jongh FHC, Devadason SG, Dhand R, Diot P, et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J. 2011;37:1308–31.CrossRefPubMed Laube BL, Janssens HM, Jongh FHC, Devadason SG, Dhand R, Diot P, et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J. 2011;37:1308–31.CrossRefPubMed
6.
go back to reference Tamura G, Sakae H, Fujino S. In vitro evaluation of dry powder inhaler devices of corticosteroid preparations. Allergol Int. 2012;61:149–54.CrossRefPubMed Tamura G, Sakae H, Fujino S. In vitro evaluation of dry powder inhaler devices of corticosteroid preparations. Allergol Int. 2012;61:149–54.CrossRefPubMed
7.
go back to reference Clark A, Hollingworth A. The relationship between powder inhaler resistance and inspiratory conditions in healthy volunteers: implications for in vitro testing. J Aerosol Med. 1993;6:99–110.CrossRefPubMed Clark A, Hollingworth A. The relationship between powder inhaler resistance and inspiratory conditions in healthy volunteers: implications for in vitro testing. J Aerosol Med. 1993;6:99–110.CrossRefPubMed
8.
go back to reference Tarsin W, Assi KH, Chrystyn H. In-Vitro intra- and inter-inhaler flow rate-dependent dosage emission from a combination of budesonide and formoterol in a dry powder inhaler. J Aerosol Med. 2004;17:25–32.CrossRefPubMed Tarsin W, Assi KH, Chrystyn H. In-Vitro intra- and inter-inhaler flow rate-dependent dosage emission from a combination of budesonide and formoterol in a dry powder inhaler. J Aerosol Med. 2004;17:25–32.CrossRefPubMed
9.
go back to reference Delvadia R, Hindle M, Longest PW, Byron PR. In vitro tests for aerosol deposition II: IVIVCs for different dry powder inhalers in normal adults. Aerosol Med Pulm Drug Deliv. 2013;26:138–44.CrossRef Delvadia R, Hindle M, Longest PW, Byron PR. In vitro tests for aerosol deposition II: IVIVCs for different dry powder inhalers in normal adults. Aerosol Med Pulm Drug Deliv. 2013;26:138–44.CrossRef
12.
go back to reference European Pharmacopoeia monograph. Preparations for Inhalations. 5th Supplement. Strasbourg: Council of Europe, 2010. European Pharmacopoeia monograph. Preparations for Inhalations. 5th Supplement. Strasbourg: Council of Europe, 2010.
14.
16.
go back to reference Borgström L, Asking L, Thorsson L. Idealhalers or realhalers? A comparison of Diskus and Turbuhaler. Int J Clin Pract. 2005;59:1488–95.CrossRefPubMed Borgström L, Asking L, Thorsson L. Idealhalers or realhalers? A comparison of Diskus and Turbuhaler. Int J Clin Pract. 2005;59:1488–95.CrossRefPubMed
17.
go back to reference Chrystyn H. Closer to an ‘ideal inhaler’ with the Easyhaler: an innovative dry powder inhaler. Clin Drug Investig. 2006;26:175–83.CrossRefPubMed Chrystyn H. Closer to an ‘ideal inhaler’ with the Easyhaler: an innovative dry powder inhaler. Clin Drug Investig. 2006;26:175–83.CrossRefPubMed
18.
go back to reference Chrystyn H, Haahtela T. Real-life inhalation therapy—inhaler performance and patient education matter. Eur Respir Dis. 2012;8:11–8. Chrystyn H, Haahtela T. Real-life inhalation therapy—inhaler performance and patient education matter. Eur Respir Dis. 2012;8:11–8.
19.
go back to reference Mitchell J, Copley M, Sizer Y, Russell T, Solomon D. Adapting the abbreviated impactor measurement (AIM) concept to make appropriate inhaler aerosol measurements to compare with clinical data: a scoping study with the “Alberta” idealized throat (AIT) inlet. J Aerosol Med Pulm Drug Deliv. 2012;25:188–97.CrossRefPubMed Mitchell J, Copley M, Sizer Y, Russell T, Solomon D. Adapting the abbreviated impactor measurement (AIM) concept to make appropriate inhaler aerosol measurements to compare with clinical data: a scoping study with the “Alberta” idealized throat (AIT) inlet. J Aerosol Med Pulm Drug Deliv. 2012;25:188–97.CrossRefPubMed
20.
go back to reference Delvadia R, Hindle M, Worth Longest P, Byron PR. In vitro tests for aerosol deposition II: IVIVCs for different dry powder inhalers in normal adults. J Aerosol Med Pulm Drug Deliv. 2013;26:138–44.CrossRefPubMed Delvadia R, Hindle M, Worth Longest P, Byron PR. In vitro tests for aerosol deposition II: IVIVCs for different dry powder inhalers in normal adults. J Aerosol Med Pulm Drug Deliv. 2013;26:138–44.CrossRefPubMed
21.
go back to reference Olsson B, Borgström L, Lundbäck H, Svensson M. Validation of a general in vitro approach for prediction of total lung deposition in healthy adults for pharmaceutical inhalation products. J Aerosol Med Pulm Drug Deliv. 2013;26:355–69.CrossRefPubMed Olsson B, Borgström L, Lundbäck H, Svensson M. Validation of a general in vitro approach for prediction of total lung deposition in healthy adults for pharmaceutical inhalation products. J Aerosol Med Pulm Drug Deliv. 2013;26:355–69.CrossRefPubMed
22.
go back to reference De Koning JP. Dry powder inhalation: technical and physiological aspects, prescribing and use. Doctoral thesis. University of Croningen (2001). De Koning JP. Dry powder inhalation: technical and physiological aspects, prescribing and use. Doctoral thesis. University of Croningen (2001).
23.
go back to reference Delvadia RR, Wei X, Longest PW, Venitz J, Byron PR. In vitro tests for aerosol deposition. IV: simulating variations in human breath profiles for realistic DPI testing. J Aerosol Med Pulm Drug Deliv. 2016;29:196–206.CrossRefPubMedPubMedCentral Delvadia RR, Wei X, Longest PW, Venitz J, Byron PR. In vitro tests for aerosol deposition. IV: simulating variations in human breath profiles for realistic DPI testing. J Aerosol Med Pulm Drug Deliv. 2016;29:196–206.CrossRefPubMedPubMedCentral
24.
go back to reference Lähelmä S, Vahteristo M, Metev H, Taseva M, Stamatova N, Bartha A, Schlezák J, Sairanen U. Equivalent bronchodilation with budesonide/formoterol combination via Easyhaler and Turbuhaler in patients with asthma. Respir Med. 2016;120:31–5.CrossRefPubMed Lähelmä S, Vahteristo M, Metev H, Taseva M, Stamatova N, Bartha A, Schlezák J, Sairanen U. Equivalent bronchodilation with budesonide/formoterol combination via Easyhaler and Turbuhaler in patients with asthma. Respir Med. 2016;120:31–5.CrossRefPubMed
25.
go back to reference Palander A, Mattila T, Karhu M, Muttonen E. In vitro comparison of three salbutamol-containing multidose dry powder inhalers. Buventol Easyhaler®, Inspiryl Turbuhaler® and Ventoline Diskus®. Clin Drug Investig. 2000;20:25–33.CrossRef Palander A, Mattila T, Karhu M, Muttonen E. In vitro comparison of three salbutamol-containing multidose dry powder inhalers. Buventol Easyhaler®, Inspiryl Turbuhaler® and Ventoline Diskus®. Clin Drug Investig. 2000;20:25–33.CrossRef
26.
go back to reference Koning JP, Mark TW, Coenegracht PM, Tromp TF, Frijlink HW. Effect of an external resistance to airflow on the inspiratory flow curve. Int J Pharm. 2002;234:257–66.CrossRefPubMed Koning JP, Mark TW, Coenegracht PM, Tromp TF, Frijlink HW. Effect of an external resistance to airflow on the inspiratory flow curve. Int J Pharm. 2002;234:257–66.CrossRefPubMed
27.
go back to reference Lööf T, Elfman P, Ström P, Törngren A, Borgström L. Sustained mechanical and clinical functionality of the Flexhaler dry powder inhaler. J Aerosol Med Pulm Drug Deliv. 2008;21:381–8.CrossRefPubMed Lööf T, Elfman P, Ström P, Törngren A, Borgström L. Sustained mechanical and clinical functionality of the Flexhaler dry powder inhaler. J Aerosol Med Pulm Drug Deliv. 2008;21:381–8.CrossRefPubMed
28.
go back to reference Ross DL, Schultz RK. Effect of inhalation flow rate on the dosing characteristics of dry powder inhaler (DPI) and metered dose inhaler (MDI) products. J Aerosol Med. 1996;9:215–26.CrossRefPubMed Ross DL, Schultz RK. Effect of inhalation flow rate on the dosing characteristics of dry powder inhaler (DPI) and metered dose inhaler (MDI) products. J Aerosol Med. 1996;9:215–26.CrossRefPubMed
29.
go back to reference Hindle M, Byron PR. Dose emissions from marketed dry powder inhalers. Int J Pharm. 1995;116:169–77.CrossRef Hindle M, Byron PR. Dose emissions from marketed dry powder inhalers. Int J Pharm. 1995;116:169–77.CrossRef
30.
go back to reference Malton A, Sumby BS, Smit IJ. A comparison of in vitro dose delivery from two multidose powder inhalation devices. Eur J Clin Res. 1995;7:177–93. Malton A, Sumby BS, Smit IJ. A comparison of in vitro dose delivery from two multidose powder inhalation devices. Eur J Clin Res. 1995;7:177–93.
31.
go back to reference Brown PH, Ning ACWS, Greening AP, McLean A, Crompton GK. Peak inspiratory peak flow through Turbuhaler in acute asthma. Eur Respir J. 1995;8:1940–1.CrossRefPubMed Brown PH, Ning ACWS, Greening AP, McLean A, Crompton GK. Peak inspiratory peak flow through Turbuhaler in acute asthma. Eur Respir J. 1995;8:1940–1.CrossRefPubMed
32.
go back to reference Frijlink HW, Boer AH. Dry powder inhalers for pulmonary drug delivery. Expert Opin Drug Deliv. 2004;1:67–86.CrossRefPubMed Frijlink HW, Boer AH. Dry powder inhalers for pulmonary drug delivery. Expert Opin Drug Deliv. 2004;1:67–86.CrossRefPubMed
33.
go back to reference Andersen PB, Hanssen NCG. Which magnitude of inhaler resistance against airflow is preferred by patients using dry powder inhalers. Eur Respir J. 1993;6:148s. Andersen PB, Hanssen NCG. Which magnitude of inhaler resistance against airflow is preferred by patients using dry powder inhalers. Eur Respir J. 1993;6:148s.
34.
go back to reference Boer AH, Winter HMI, Lerk CF. Inhalation characteristics and their effect on in vitro drug delivery from dry powder inhalers, part 1, inhalation characteristics, work of breathing and volunteers’ preference in dependence of the inhaler resistance. Int J pharm. 1996;130:231–44.CrossRef Boer AH, Winter HMI, Lerk CF. Inhalation characteristics and their effect on in vitro drug delivery from dry powder inhalers, part 1, inhalation characteristics, work of breathing and volunteers’ preference in dependence of the inhaler resistance. Int J pharm. 1996;130:231–44.CrossRef
Metadata
Title
Budesonide/Formoterol Easyhaler®: Performance Under Simulated Real-Life Conditions
Authors
Jussi Haikarainen
Olof Selroos
Tero Löytänä
Sirpa Metsärinne
Anita Happonen
Paula Rytilä
Publication date
01-06-2017
Publisher
Springer Healthcare
Published in
Pulmonary Therapy / Issue 1/2017
Print ISSN: 2364-1754
Electronic ISSN: 2364-1746
DOI
https://doi.org/10.1007/s41030-016-0025-z

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