Salbutamol DPI as effective as budesonide-formoterol to relieve methacholine induced bronchoconstriction: Study

A recent research published in the recent issue of Respiratory Medicine journal found Salbutamol Easyhaler as a safe and sustainable reliever for the methacholine challenge test (MC) and is recommended for usage during asthma attacks. It also demonstrates that Salbutamol Easyhaler is not inferior to Ventoline Evohaler with spacer in reducing acute bronchoconstriction.

For individuals with airway conditions including asthma and chronic obstructive pulmonary disease, inhalation is the recommended method of medicine delivery. Salbutamol, a short-acting β2-agonist has long been a mainstay in the management of acute asthma symptoms including dyspnea. For asthma, budesonide and formoterol together are used as a maintenance medication and it has been demonstrated that using it as maintenance and relief treatment (MART) lowers the relative chance of undergoing severe asthma attacks. The coordination issue is resolved by dry powder inhalers (DPIs), which are simpler to operate and breath-actuated than particulate matter detectors (pMDIs). Therefore, Jussi Karjalainen and colleagues wanted to demonstrate the non-inferiority of Salbutamol Easyhaler dry powder inhalers versus Ventoline Evohaler pMDI with Volumatic spacer in treating methacholine-induced bronchoconstriction.

The participants in this randomized, parallel-group experiment underwent the methacholine challenge test to diagnose asthma. As a relief, participants with a minimum 20% reduction in forced expiratory volume in 1 second (FEV1) were randomly assigned to receive either Budesonide-formoterol Easyhaler (2 × 160/4.5 μg), Ventoline Evohaler with spacer (4 × 100 μg), or salbutamol Easyhaler (2 × 200 μg). If the FEV1 did not return to at least −10% of baseline, the therapy was repeated.

The experiment was completed by a total of 180 individuals (69 % females, mean age 46 years [range 18–80], FEV1%pred 89.5 [62–142] %). Salbutamol Easyhaler demonstrated a difference in FEV1 of −0.083 (95 % LCL -0.146) L after the first dosage and −0.032 (−0.071) L after the last dose which indicated non inferiority to pMDI with spacer in terms of immediate alleviation of bronchoconstriction. Salbutamol pMDI and Budesonide-formoterol Easyhaler with spacer had FEV1 differences of -0.163 (-0.225) L after the first dosage and -0.092 (-0.131) L after the last.

Overall, this study demonstrates that Salbutamol Easyhaler is equally effective as Ventoline Evohaler with Volumatic spacer, when it comes to treating acute obstructive events. The results of the MC test justify the use of Easyhaler DPI as an ecologically friendly option for administering a relieving drug during an asthma attack or exacerbation.

Source:

Karjalainen, J., Vartiainen, V., Tikkakoski, A., Malmberg, L. P., Vuotari, L., Lähelmä, S., Sairanen, U., Vahteristo, M., & Lehtimäki, L. (2024). Salbutamol Easyhaler provides non-inferior relief of methacholine induced bronchoconstriction in comparison to Ventoline Evohaler with spacer: A randomized trial. In Respiratory Medicine (Vol. 230, p. 107693). Elsevier BV. https://doi.org/10.1016/j.rmed.2024.107693