A comparison of the lung deposition of budesonide from Easyhaler®, Turbuhaler® and pMDI plus spacer in asthmatic patients

Inhaled corticosteroids in pressurized metered does inhalers (pMDIs) are often delivered via a large volume spacer device, but these are bulky and inconvenient. Dry powder inhalers (DPIs) provide a highly portable and convenient propellant-free alternative to pMDIs for asthma maintenance therapy However, each DPI could have unique in vivo delivery characteristics. In order to quantify the total and regional lung deposition of budesonide (200 mug) from (a) Easyhaler(R), (b) Turbuhaler(R) and (c) pMDI plus Nebuhaler(R) 750 ml spacer, a three-way randomized cross-over study was carried out in 12 mild to moderate asthmatic patients. Deposition was quantified by the imaging technique of gamma scintigraphy. Optimal inhalation techniques were used throughout. Mean (SD) whole lung deposition (% metered dose) was similar for Easyhaler(R) [18.5 (7.8) %] and Turbuhaler(R) [21.8 (8.2) %], but was significantly higher for pMDI plus Nebuhaler(R) [44.1 (10.0) %, P < 0.01]. The regional distribution patterns in the lungs were predominantly central for all three devices. Nebuhaler(R) reduced oropharyngeal deposition significantly compared with the two DPIs. Easyhaler(R) Showed comparable deposition to Turbuhaler(R) and hence drugs delivered by Easyhaler(R) would be expected to have a similar clinical effect to those delivered by Turbuhaler(R) in asthma maintenance therapy, (C) 2001 Harcourt Publishers Ltd.