INHALATION PARAMETERS IN PATIENTS WITH ASTHMA USING ALBUTEROL ELECTRONIC MULTI-DOSE DRY POWDER INHALER

SESSION TITLE: Updates in the Management of Severe Asthma SESSION TYPE: Original Investigations PRESENTED ON: October 18-21, 2020 PURPOSE: Inhalation therapy is the mainstay of asthma treatment. Despite inhaler technique demonstration in clinical practice or study visits, patients do not maintain correct technique at home and errors are common. ProAir Digihaler (albuterol 90 µg/dose) is an electronic multi dose dry powder inhaler designed with an integrated electronic module to record objective information on inhaler usage and inhalation parameters, and thereby technique. METHODS: This post-hoc observation of data from a 12-week, open-label study, assessed inhalation parameter changes in patients (≥18 years old) with exacerbation-prone asthma. Patients used the Digihaler (1–2 inhalations, every 4 hours) as needed, passively recording albuterol use and inhalation parameters (peak inspiratory flow [PIF], inhalation volume, and inhalation duration). RESULTS: Patients with ≥1 valid inhalation (n=360) from the Digihaler were included in the analysis. Inhalation parameters varied both over the duration of the study, and during a single day. Most patients generated the minimum PIF threshold of 30 L/min all the time, regardless of exacerbation. Some patients showed consistent patterns in inhalation parameters preceding an asthma exacerbation (increased inhaled dose, decreased PIF and inhalation volume). On average, both exacerbators and non exacerbators displayed a gradual decrease in inhalation volume and duration during the study period. CONCLUSIONS: The inhalation parameters recorded by ProAir Digihaler may indicate inhaler technique deterioration or changes in underlying airway physiology preceding an exacerbation. These data support prior evidence that patient inhaler technique wanes within days of standard-of-care inhaler training. CLINICAL IMPLICATIONS: These data could help identify patients at risk of exacerbations who might benefit from intervention from a mobile application monitoring technique or further instruction or intervention, potentially supporting improved asthma management. DISCLOSURES: Employee relationship with Teva Please note: >$100000 Added 06/04/2020 by Randall Brown, source=Web Response, value=Salary Employee relationship with Tevapharmaceuticals Please note: >$100000 Added 06/01/2020 by Michael De Pietro, source=Web Response, value=Salary No relevant relationships by Nabeel Farooqui, source=Web Response No relevant relationships by Lena Granovsky, source=Web Response Employee relationship with Teva Pharmaceuticals Please note: >$100000 Added 06/01/2020 by Tanisha Hill, source=Web Response, value=Salary no disclosure on file for Thomas Li; Consultant relationship with Teva Please note: $1-$1000 Added 04/29/2020 by Roy Pleasants, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Boehringer Ingelheim Please note: $5001 - $20000 Added 04/29/2020 by Roy Pleasants, source=Web Response, value=Honoraria Advisory Committee Member relationship with Theravance Please note: $1-$1000 Added 04/29/2020 by Roy Pleasants, source=Web Response, value=Consulting fee No relevant relationships by Michael Reich, source=Web Response Employee relationship with Teva Pharmaceuticals Please note: >$100000 Added 06/01/2020 by Guilherme Safioti, source=Web Response, value=Salary