title: Clickhaler (a novel dry powder inhaler) provides similar bronchodilation to pressurized metered-dose inhaler, even at low flow rates.
abstract: OBJECTIVE
  Comparison of the bronchodilator response to an albuterol novel dry powder inhaler (DPI) (Clickhaler [CH]; ML Laboratories PLC; St. Albans, UK) activated at various inspiratory flow rates and to an albuterol pressurized metered-dose inhaler (pMDI) by patients with moderate to moderately severe stable asthma.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled comparison of the bronchodilator response to albuterol DPI (200 microg) at inspiratory flow rates of approximately 15, 30, and 60 L/min in patients with stable asthma with demonstrated reversibility to albuterol. Active (albuterol via pMDI inhaled at 30 L/min) and placebo controls were included.
  
  
  METHODS
  Single center study at the chest/allergy unit of a teaching hospital in Canada.
  
  
  METHODS
  Sixteen patients with moderate to moderately severe stable asthma.
  
  
  RESULTS
  Efficacy end points were FEV1, FVC, FEV1/FVC, maximum expiratory flow, and forced expiratory flow between 25% and 75% of vital capacity. Safety end points included heart rate, BP, and tremor. There was no significant difference between the bronchodilator response to albuterol via the CH at 15, 30, and 60 L/min inspiratory flow rate and, at all flow rates, no significant difference was found comparing albuterol CH with the pMDI. All of the techniques for delivering albuterol provided significantly better bronchodilatation than placebo. Adverse events were minimal and did not differ between CH and pMDI or between the various flow rates inhaled through the CH.
  
  
  CONCLUSIONS
  A novel passive albuterol DPI (CH) provides a similar bronchodilator response at 15, 30, and 60 L/min inspiratory flow rates compared with a pMDI used optimally.
authors: Barnett Medical Aerosol Research Laboratory, St. Joseph's Hospital-McMaster University, Hamilton, Ontario, Canada. mikenewhouse@inhale.com
authors: M T
authors: MT
authors: Newhouse
authors: N P
authors: NP
authors: Nantel
authors: C B
authors: CB
authors: Chambers
authors: B
authors: B
authors: Pratt
authors: M
authors: M
authors: Parry-Billings
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage* / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007320:Inspiratory Capacity; D008297:Male; D008448:Maximal Expiratory Flow Rate; D008450:Maximal Midexpiratory Flow Rate; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D011208:Powders; D014797:Vital Capacity
chemical_list: D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D011208:Powders; D000420:Albuterol