Literature review on inhaler selection and device switching

Lavorini F, et al. 2021 Pulmonary Therapy 

Study Summary:

Literature review on inhaler selection and device switching — Switching to an Easyhaler device may improve asthma and COPD control without causing additional risks

• Issues in inhaler selection and device switching, with focus on the Easyhaler^® device, were summarised in a review article.¹
• The evidence showed that Easyhaler provides several benefits in the treatment of asthma and COPD.
• Easyhaler provided consistent drug delivery even at low inspiratory flow rates.
• Easyhaler was found to be easy to teach, learn, and use.
• Patients reported high satisfaction with Easyhaler and preferred it over other inhalers.
• Authors concluded that switching inhaler device to Easyhaler may improve asthma and COPD control without causing additional risks.

Success in treating asthma and chronic obstructive pulmonary disease (COPD) may depend on inhaler choice, as poor inhaler practice contributes to suboptimal clinical control in these diseases. In a review article published in 2021, asthma and COPD experts from various European countries addressed issues in inhaler selection and device switching, with a focus on the Easyhaler^® device.¹ The review concluded that Easyhaler provides several benefits for treatment of asthma and COPD.

The evidence showed that Easyhaler provides consistent drug delivery at low respiratory rates (>30 l/min) and inhalation volumes (down to 0.5 l) which makes Easyhaler suitable for the majority of patients with asthma or COPD regardless of age or disease severity. In addition, the drug delivery performance of Easyhaler was robust throughout the inhaler’s lifespan and was unaffected by environmental stress such as dropping, vibration, moisture, and freeze-thawing.

Patients were more satisfied with Easyhaler and preferred it over other DPIs or other types of inhalers. Almost all patients (97.2%) reported high satisfaction with Easyhaler (Fig. 2).

^{Figure 2. Almost all patients were satisfied with Easyhaler (n=621 patients with asthma, n=778 patients with COPD, n=99 ACO). A total of 455 of patients (30.4%) were newly diagnosed inhaler-naïve patients, and 1,043 (69.6%) were switching from other inhalers. Comparisons with metered-dose inhaler (MDI), Diskus/Accuhaler and Turbuhaler are shown. ACO; asthma/chronic obstructive pulmonary disease overlap. Adapted from Tamási L, et al. 2018. (Reference 2)}

Furthermore, a majority of physicians (>90%) reported Easyhaler as quick and easy to teach, and patients reported Easyhaler to be easy to learn and use. Patients also made fewer critical errors with Easyhaler than with other inhalers (Fig. 3). Critical errors of inhaler use were strongly related to poor asthma control.

^{Figure 3. Significantly fewer critical mistakes were recorded among Easyhaler users versus other dry-powder inhaler users (10.3% vs 18.4%; P<0.05). Patients with asthma were referred from primary to specialist care for the first time. Adapted from Ribó P, et al. 2019. (reference 3)}

In addition, the review reported that the carbon footprint of DPIs such as Easyhaler is lower than the carbon footprint of MDIs which contain propellants that are powerful greenhouse gases. Switching to DPIs such as Easyhaler has been proposed as a cost-effective way to reduce emissions.

In conclusion, Easyhaler presented several benefits exemplified by consistent drug delivery across a wide range of peak inspiratory flow rates, few critical errors in use, high patient satisfaction, and a reduction in the emission of greenhouse gases. Finally, the experts concluded that switching to Easyhaler may improve asthma and COPD control and can be done without any additional risks.

Study: Lavorini F, et al. 2021 Pulmonary Therapy 

For further insights on benefits of choosing Easyhaler, see:

Budesonide/Formoterol Easyhaler®: performance under simulated real-life conditions

Easyhaler^® provides accurate and consistent dosing across varying patient inhalation flow rates.

Evaluation of the efficiency of single-inhaler combination therapy with budesonide/formoterol fumarate in patients with bronchial asthma in daily clinical practice

References

1. Lavorini F, et al. 2021
2. Tamási L, Szilasi M, Gálffy G. Clinical effectiveness of budesonide/formoterol fumarate Easyhaler® for patients with poorly controlled obstructive airway disease: A real-world study of patient-reported outcomes. Adv Ther. 2018;35:1140–52.
3. Ribó P, Molina J, Calle M, et al. Prevalence of modifiable factors limiting treatment efficacy of poorly controlled asthma patients: EFIMERA observational study. NPJ Prim Care Respir Med. 2020;30:33.