Comparison of Easyhaler?? Metered-Dose, Dry Powder Inhaler and a Pressurised Metered-Dose Inhaler plus Spacer in the Treatment of Asthma in Children

Abstract

The aim of this study was to compare the preference, efficacy and tolerability of Easyhaler®, a metered-dose, dry powder inhaler, with a pressurised metered-dose inhaler (pMDI) plus spacer in the treatment of asthma in children. Forty-three asthmatic children, aged 6–16 years, were enrolled in this open, crossover study. All the children were previously treated with inhaled corticosteroids. After a two-week run-in period, patients were randomised to either salbutamol via Easyhaler® 100 μg/day (Buventol Easyhaler®) and beclomethasone dipropionate via Easyhaler® (Beclomet Easyhaler®) 400 μg/day, or salbutamol pMDI plus spacer 100 μg/day and beclomethasone dipropionate pMDI plus spacer 400 μg/day After a four-week treatment period the medication was changed in a crossover manner. The preference of the inhalers was assessed after each treatment period using a 10-point rating scale. Patient perceptions of the two inhalers were further investigated using a questionnaire, which was completed at the end of the study. The primary efficacy variable was morning peak expiratory flow (PEF). Secondary efficacy variables were evening PEF, the number of sympathomimetic inhalations, daily symptom scores, and spirometry performed at the follow-up visits. The results of the questionnaire showed that in 11 of 14 questions more than 50% of the patients preferred Easyhaler® to pMDI plus spacer, and Easyhaler® was found to be significantly easier to handle than pMDI plus spacer: mean (SD) score for Easyhaler was 7.7 (2.1), compared with 6.6 (2.1) for pMDI. Lung function values remained stable with both treatments. Throughout the study salbutamol delivered via Easyhaler® produced equivalent bronchodilation to pMDI plus spacer. There were no significant differences in asthma symptom scores and the use of rescue medication between the two treatment regimens. Fewer patients reported adverse events during treatment with Easyhaler® (13) compared with pMDI plus spacer (16). Asthma therapy delivered via Easyhaler® was more acceptable to patients than the same therapy delivered via pMDI plus spacer. There were no significant differences in the efficacy of treatments, and they were equally well tolerated.