Lung deposition of extrafine inhaled corticosteroid (ICS)-containing fixed combinations drug in COPD patients using Functional Respiratory Imaging (FRI).

Abstract

Introduction: FRI is a novel computational fluid dynamics (CFD)-based technique using formulation profile and patients lung CT scan to simulate aerosol deposition. Aims and objectives: To evaluate lung deposition of pressurized metered dose inhaler (pMDI) extrafine beclometasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G Trimbow®) with pMDI extrafine BDP/FF (Foster®) pMDI and compared them with reference gamma scintigraphy data. Methods: FRI was used to assess, in silico, the deposition of pMDI combination products (BDP/FF/G and BDP/FF) in 20 moderate to severe COPD patients. FRI combined high-resolution lung CT scans of each patient with in silico computational flow simulations, and incorporated the drug delivery parameters of the two pMDI products to calculate aerosol airway deposition. Inhalation was simulated using a per-patient profile obtained from real life measurement. Results: Intrathoracic extrafine BDP/FF deposition was high and comparable for both products. Moreover, the findings showed good agreement with scintigraphy data by De Backer (J Aerosol Med Pulm Drug Deliv 2010; Table 1). Conclusions: FRI is an accurate tool and a suitable novel technology when assessing pMDI lung deposition. FRI deposition data obtained with extrafine BDP/FF/G support a high lung deposition and confirm that its deposition profile is comparable to extrafine BDP/FF.