title: Respiratory Tract Deposition of HFA-Beclomethasone and HFA-Fluticasone in Asthmatic Patients.
abstract: BACKGROUND
  The asthmatic patient's respiratory tract deposition of HFA fluticasone (Flovent HFA(™)) has not been established. There is a known large particle size difference with another commercial inhaled HFA steroid (QVAR(™)). This study compared the 2D and 3D respiratory tract deposition of each inhaled steroid.
  
  
  METHODS
  This study was an open label, crossover study in eight patients diagnosed with asthma. The regional respiratory and oropharyngeal deposition of the two steroids were compared and contrasted using planar and SPECT imaging following delivery of the (99m)Tc-radiolabeled drug in each product. The SPECT images were merged with computed tomography images to quantify regional deposition within the patients.
  
  
  RESULTS
  Two-dimensional (2D) planar images indicated that 24% of the Flovent HFA dose and 55% of the QVAR dose deposited in the lungs. 2D oropharyngeal deposition indicated that 75% of the Flovent HFA dose was deposited in the oropharynx, while 42% of the QVAR dose deposited in the oropharynx. Three-dimensional (3D) SPECT data indicated that 22% of the Flovent HFA dose and 53% of the QVAR dose deposited in the lungs. 3D oropharyngeal and gut deposition indicated 78% of the Flovent HFA dose was deposited in the oropharynx, while 47% of the QVAR dose deposited in the oropharynx. The increased lung deposition and decreased oropharynx deposition for both 2D and 3D image data of QVAR were statistically different from Flovent HFA.
  
  
  CONCLUSIONS
  QVAR exhibited a significant increase in lung delivery compared to Flovent HFA. Conversely, QVAR delivered a significantly lower dose to the oropharynx than Flovent HFA. The findings were presumed to be driven by the smaller particle size of QVAR (0.7 microns MMAD) compared with Flovent HFA (2.0 microns MMAD).
authors.affiliation: Lovelace Respiratory Research Institute , Albuquerque, New Mexico.
authors.forename: Chet L
authors.initials: CL
authors.lastname: Leach
authors.affiliation: Lovelace Respiratory Research Institute , Albuquerque, New Mexico.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Kuehl
authors.affiliation: Lovelace Respiratory Research Institute , Albuquerque, New Mexico.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Chand
authors.affiliation: Lovelace Respiratory Research Institute , Albuquerque, New Mexico.
authors.forename: Jacob D
authors.initials: JD
authors.lastname: McDonald
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000335:Aerosol Propellants / Q000737:chemistry; D000336:Aerosols; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000737:chemistry / Q000378:metabolism*; D001249:Asthma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D001507:Beclomethasone / Q000008:administration & dosage / Q000737:chemistry / Q000378:metabolism*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000737:chemistry / Q000378:metabolism*; D018592:Cross-Over Studies; D004339:Drug Compounding; D000068298:Fluticasone / Q000008:administration & dosage / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000737:chemistry; D008168:Lung / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D036501:Metered Dose Inhalers; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009960:Oropharynx / Q000378:metabolism; D010316:Particle Size; D011857:Radiographic Image Interpretation, Computer-Assisted; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000335:Aerosol Propellants; D000336:Aerosols; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D006845:Hydrocarbons, Fluorinated; D000068298:Fluticasone; D001507:Beclomethasone
keywords: aerosol distribution; clinical trial; inhaled therapy; metered dose inhaler; scintigraphy