A comparison of the lung deposition of budesonide from Easyhaler®, Turbuhaler®and pMDI plus spacer in asthmatic patients

AbstractInhaled corticosteroids in pressurized metered does inhalers (pMDIs) are often delivered via a large volume spacer device, but these are bulky and inconvenient. Dry powder inhalers (DPIs) provide a highly portable and convenient propellant-free alternative to pMDIs for asthma maintenance therapy. However, each DPI could have unique in vivo delivery characteristics. In order to quantify the total and regional lung deposition of budesonide (200 μ g) from (a) Easyhaler®, (b) Turbuhaler®and (c) pMDI plus Nebuhaler®750 ml spacer, a three-way randomized cross-over study was carried out in 12 mild to moderate asthmatic patients. Deposition was quantified by the imaging technique of gamma scintigraphy. Optimal inhalation techniques were used throughout. Mean (SD) whole lung deposition (% metered dose) was similar for Easyhaler®[18·5 (7·8) %] and Turbuhaler®[21·8 (8·2) %], but was significantly higher for pMDI plus Nebuhaler®[44·1 (10·0) %, P