Switching to pressurized metered-dose inhaler improves asthma control, says study

Delhi: Switching from a dry powder inhaler (DPI) to a pressurized metered-dose inhaler (pMDI) decreased exacerbations and improved disease control in asthma patients, reveals a recent study published in the journal Respirology. This was observed in the patients treated with fixed-dose combination inhaled corticosteroid/long-acting β₂-agonist (FDC ICS/LABA).

The use of a mixed inhaler for asthma treatment results in worse inhaler technique and outcomes. Changing preventers from dry powder inhalers to pMDI may improve asthma outcome provide that relievers are commonly prescribed as pressurized metred‐dose inhalers.

The study included 2 cohorts: a total switch cohort and an effectiveness cohort. The total switch cohort sought to assess the persistence of a switch from the previous DPI to a pMDI prescription. This cohort included a 1-year baseline period and a 6-month outcome period. The purpose of the effectiveness cohort was to assess the effectiveness of switching from a DPI to a pMDI. This cohort included a 1-year baseline period for patient characterization prior to the index date (ie, the date of first pMDI prescription) and a 1-year outcome period for endpoint measures.

• Within 85 patients who switched from DPI to pMDI and persisted for a year, a higher proportion were free from asthma exacerbation after the switch.


• Switching to pMDI was also associated with better RDAC (75.3% vs 57.7%) and OAC (57.7% vs 45.9%).


• From the entire 117 patients who switched to fixed‐dose combination (FDC)/ICS LABA pMDI, 76.1% of patients persisted in the following 6 months.

"The findings from this study demonstrated that in a real-life specialist asthma setting, switching from an FDC ICS/LABA to a pMDI was associated with a significantly lower proportion of patients who experienced severe asthma exacerbations and was linked to better asthma control compared with the prior year when the patients were on DPI prescriptions," concluded the authors. "The majority of patients maintained the switch for ≥6 months."