title: Salbutamol dry powder inhaler: efficacy, tolerability, and acceptability study.
abstract: Dry powder inhaler (DPI) devices are frequently used in children over 5 years of age in order to avoid coordination difficulties often seen with the use of pressurized metered dose inhalers (pMDI). This study assessed the efficacy, tolerability, and acceptability of salbutamol delivered via two delivery systems, in a population of pediatric patients. The primary aim of the study was to investigate the bronchodilator efficacy of a single dose (100 microg) of salbutamol administered via a dry powder inhaler (Clickhaler) compared to a similar dose administered by a pressurized metered dose inhaler via a large-valved holding chamber (VHC) to children with asthma. The study comprised two phases: the first comparator phase, followed by an open 4-week treatment period. Sixty-one children with a mean (SD) age of 11.3 years (2.9) (range, 6-17) and mild or moderate asthma completed the study. The primary efficacy endpoint, forced expiratory volume in 1 sec (FEV1), indicated that there was no clinically or statistically significant difference between the bronchodilator effects of salbutamol delivered via either device, with a maximum posttreatment percentage change in FEV1 (SD) of 12.4% (10.0) and 14.15 (9.3) for Clickhaler and pMDI plus VHC, respectively. Most patients rated the Clickhaler as easy to use (97%) and liked the device (84%). Both treatments were well--tolerated. These results support the suitability of salbutamol Clickhaler as an acceptable, well-tolerated, and effective alternative to a pMDI plus VHC in mild to moderate asthmatic children over age 6 years.
authors.affiliation: Department of Child Health, Leicester Royal Infirmary, Leicester, UK. ajb64@le.ac.uk
authors.forename: Chris
authors.initials: C
authors.lastname: O'Callaghan
authors.forename: Mark L
authors.initials: ML
authors.lastname: Everard
authors.forename: Andrew
authors.initials: A
authors.lastname: Bush
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Hiller
authors.forename: Robert
authors.initials: R
authors.lastname: Ross-Russell
authors.forename: Peter
authors.initials: P
authors.lastname: O'Keefe
authors.forename: Peter
authors.initials: P
authors.lastname: Weller
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage* / Q000627:therapeutic use; D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D011208:Powders; D016896:Treatment Outcome
chemical_list: D000318:Adrenergic beta-Agonists; D011208:Powders; D000420:Albuterol