CHEST Annual Meeting

CHEST Annual Meeting

Source:

Farooqui N, et al. Updates in the management of severe asthma. Presented at: CHEST Annual Meeting 2020; Oct. 18-22, 2020 (virtual meeting).

Disclosures: The study was funded by Teva. Farooqui is a scientific adviser for Teva.
October 22, 2020
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Inhalation parameters recorded by digital asthma device can signal waning inhaler method

Source:

Farooqui N, et al. Updates in the management of severe asthma. Presented at: CHEST Annual Meeting 2020; Oct. 18-22, 2020 (virtual meeting).

Disclosures: The study was funded by Teva. Farooqui is a scientific adviser for Teva.
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Inhalation parameters recorded by a digital asthma device can be used to indicate inhaler technique deterioration, which often wanes soon after patients receive training, researchers reported at the virtual CHEST Annual Meeting.

Researchers conducted a post hoc analysis of a 12-week, open-label study to assess changes in asthma inhaler technique in adults with exacerbation-prone asthma. Patients used the ProAir Digihaler (Teva Pharmaceuticals Industries), an electronic, multidose dry powder rescue inhaler that delivers 90 µg albuterol per dose and records the time and inhalation profile of each inhalation, with one to two inhalations every 4 hours as needed. The ProAir Digihaler contains an electronic module to record information on inhaler usage and inhalation patterns, including peak inspiratory flow, inhalation volume and duration of inhalation.

Asthma Inhalers
Source: Adobe Stock.

“Inhalation therapy for asthma treatment is highly reliant on correct inhaler technique for optimal deposition of medication and errors in this are frequent and common,” Nabeel Farooqui, MD, FAAAAI, FACAAI, allergy and immunology specialist at Allergy Partners of Fishers in Indianapolis, said during his presentation. “ProAir Digihaler allows for greater understanding of inhaler usage in respiratory patient populations.”

Sixty-four patients (mean age, 52 years; 55% women) experienced 78 asthma exacerbations. Asthma episodes were defined as a series of inhaler events with no longer than 60 seconds between consecutive events. Fifty-eight percent of episodes consisted of one inhalation, 35.9% two inhalations, 3.5% three or more inhalations,1% four inhalations and 0.9% four or more inhalations.

Researchers observed varied patterns in use and inhalation parameters during the study, as well as during a single day. Most patients generated the minimum peak inspiratory flow threshold of 30 L per minute, regardless of whether they were experiencing an exacerbation, according to the results. Farooqi presented examples from individual patients that demonstrated consistent patterns in inhalation parameters before an exacerbation, such as increase in mean daily number of inhalations, decreased peak inspiratory flow and decreased inhalation volume. He also noted a varied pattern in the recorded data among individual patients of inhalation at some points in time, single inhalations at some points and events where patients opened and closed the cover without taking medication. The recorded data showed a trend toward decrease in inhalation volume and duration during the study period among patients both with and without exacerbations.

“These data are consistent with previous reports that patient inhaler technique wanes within days of standard-of-care training,” Farooqui said. “Clinical implications could be that this data could help identify patients at risk of exacerbations who might benefit from a targeted intervention to improve technique. The availability of objective inhaler use data could help facilitate provider-patient dialogue, shared decision-making and may lead to improved asthma outcomes.”

Reference:

Farooqui N, et al. Chest. 2020;doi:10.1016/j.chest.2020.08.073.