The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
David Price - One of the best experts on this subject based on the ideXlab platform.
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an innovative corticosteroid long acting β2 agonist breath triggered Inhaler facilitating lung delivery of fluticasone propionate formoterol fumarate for the treatment of asthma
Expert Opinion on Drug Delivery, 2019Co-Authors: Omar S. Usmani, Nicolas Roche, Jonathan Marshall, Helen Danagher, David PriceAbstract:Introduction: Incorrect Inhaler technique is one reason why the efficacies of inhaled asthma treatments in clinical trials and effectiveness in the real world differ. Inhaler technique is critical for drug delivery to the lungs; incorrect technique negatively impacts asthma control and long-term outcomes. Breath-triggered Inhalers (BTIs) can simplify drug administration and are suitable for most patients, including those with reduced inspiratory flow. Until recently, no inhaled corticosteroid/long-acting β2-agonist combination BTI was available in Europe. The flutiform® (fluticasone propionate/formoterol fumarate [FP/FORM]) k-haler® is the first combination BTI now approved in Europe for asthma maintenance treatment.Areas covered: We review studies examining the challenges posed to patients by different Inhaler types and explore evidence demonstrating the clinical efficacy of FP/FORM administered via a pressurized metered-dose Inhaler. We also review the pharmacokinetic/pharmacodynamic studies supporting FP/FORM k-haler use, and consider data showing high lung deposition with the device. Finally, we review patient experiences using the BTI, device characteristics, and health economic aspects.Expert opinion: Despite the availability of therapies, asthma control levels remain low, and there is a clear need for easy-to-use Inhalers. Research to increase our understanding of critical errors with each Inhaler and how to overcome them is important for improving care.Abbreviations: AUCt: area under the plasma concentration-time curve from the time of dosing to the last measurable concentration; BDP: beclometasone dipropionate; BTI: breath-triggered Inhaler; BUD: budesonide; CI: confidence interval; Cmax: maximum observed plasma concentration; DPI: dry powder Inhaler; FDC: fixed-dose combination; FEV1: forced expiratory volume in 1 s; FORM: formoterol fumarate; FP: fluticasone propionate; HCP: health-care professional; ICS: inhaled corticosteroid; LABA: long-acting β2-agonist; OR: odds ratio; PIL: patient information leaflet; pMDI: pressurized metered-dose Inhaler; SAL: salmeterol xinafoate.
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Inhaler errors in the critikal study type frequency and association with asthma outcomes
The Journal of Allergy and Clinical Immunology: In Practice, 2017Co-Authors: David Price, Sinthia Bosnicanticevich, John Haughney, Miguel Romanrodriguez, Brett R Mcqueen, Victoria Carter, Kevin Gruffyddjones, Svein Hoegh Henrichsen, Catherine Hutton, Antonio InfantinoAbstract:Background Poor Inhaler technique has been linked to poor asthma outcomes. Training can reduce the number of Inhaler errors, but it is unknown which errors have the greatest impact on asthma outcomes. Objective The CRITical Inhaler mistaKes and Asthma controL study investigated the association between specific Inhaler errors and asthma outcomes. Methods This analysis used data from the iHARP asthma review service—a multicenter cross-sectional study of adults with asthma. The review took place between 2011 and 2014 and captured data from more than 5000 patients on demographic characteristics, asthma symptoms, and Inhaler errors observed by purposefully trained health care professionals. People with asthma receiving a fixed-dose combination treatment with inhaled corticosteroids and long-acting beta agonist were categorized by the controller Inhaler device they used—dry-powder Inhalers or metered-dose Inhalers: Inhaler errors were analyzed within device cohorts. Error frequency, asthma symptom control, and exacerbation rate were analyzed to identify critical errors. Results This report contains data from 3660 patients. Insufficient inspiratory effort was common (made by 32%-38% of dry-powder Inhaler users) and was associated with uncontrolled asthma (adjusted odds ratios [95% CI], 1.30 [1.08-1.57] and 1.56 [1.17-2.07] in those using Turbohaler and Diskus devices, respectively) and increased exacerbation rate. In metered-dose Inhaler users, actuation before inhalation (24.9% of patients) was associated with uncontrolled asthma (1.55 [1.11-2.16]). Several more generic and device-specific errors were also identified as critical. Conclusions Specific Inhaler errors have been identified as critical errors, evidenced by frequency and association with asthma outcomes. Asthma management should target Inhaler training to reduce key critical errors.
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trying but failing the role of Inhaler technique and mode of delivery in respiratory medication adherence
The Journal of Allergy and Clinical Immunology: In Practice, 2016Co-Authors: Fulvio Braido, Henry Chrystyn, Sinthia Bosnicanticevich, Victoria Carter, Ilaria Baiardini, Thys Van Der Molen, Ronald J Dandurand, Alison Chisholm, David PriceAbstract:Inhaled therapies are the backbone of asthma and chronic obstructive pulmonary disease management, helping to target therapy at the airways. Adherence to prescribed treatment is necessary to ensure achievement of the clinician's desired therapeutic effect. In the case of inhaled therapies, this requires patients' acceptance of their need for inhaled therapy together with successful mastery of the Inhaler technique specific to their device(s). This article reviews a number of challenges and barriers that inhaled mode of delivery can pose to optimum adherence—to therapy initiation and, thereafter, to successful implementation and persistence. The potential effects on adherence of different categories of devices, their use in multiplicity, and the mixing of device categories are discussed. Common Inhaler errors identified by the international Implementing Helping Asthma in Real People (iHARP) study are summarized, and adherence intervention opportunities for health care professionals are offered. Better knowledge of common errors can help practicing clinicians identify their occurrence among patients and prompt remedial actions, such as tailored education, Inhaler technique retraining, and/or shared decision making with patients regarding suitable alternatives. Optimizing existing therapy delivery, or switching to a suitable alternative, can help avoid unnecessary escalation of treatment and health care resources.
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Inhaler competence in asthma common errors barriers to use and recommended solutions
Respiratory Medicine, 2013Co-Authors: David Price, Henry Chrystyn, Sinthia Bosnicanticevich, Andrew Briggs, C S Rand, G Scheuch, J BousquetAbstract:Whilst the inhaled route is the first line administration method in the management of asthma, it is well documented that patients can have problems adopting the correct Inhaler technique and thus receiving adequate medication. This applies equally to metered dose Inhalers and dry powder Inhalers and leads to poor disease control and increased healthcare costs. Reviews have highlighted these problems and the recent European Consensus Statement developed a call to action to seek solutions. This review takes forward the challenge of Inhaler competence by highlighting the issues and suggesting potential solutions to these problems. The opportunity for technological innovation and educational interventions to reduce errors is highlighted, as well as the specific challenges faced by children. This review is intended as a policy document, as most issues faced by patients have not changed for half a century, and this situation should not be allowed to continue any longer. Future direction with respect to research, policy needs and practice, together with education requirements in Inhaler technique are described.
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not all asthma Inhalers are the same factors to consider when prescribing an Inhaler
Primary Care Respiratory Journal, 2009Co-Authors: Henry Chrystyn, David PriceAbstract:National and international asthma guidelines stress that before making changes to patients' therapy their compliance and Inhaler technique should be checked. This review addresses these issues and highlights the differences between Inhalers in terms of Inhaler technique, individual ability/competence, and ease of use. The advantages and disadvantages of metered-dose Inhalers (MDIs) and dry powder Inhalers (DPIs) are presented. The reformulation of beclometasone MDIs is discussed since there has been some confusion over prescribing and Regulatory Authorities have recommended that these should be prescribed by brand name and not generically. This review should provide prescribers with an update to help them appreciate the differences between Inhalers thereby optimising each patient's inhaled treatment.
Alfredo Chetta - One of the best experts on this subject based on the ideXlab platform.
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Inhaled beclometasone dipropionate/formoterol fumarate extrafine fixed combination for the treatment of asthma
Expert Review of Respiratory Medicine, 2016Co-Authors: Ernesto Crisafulli, Gianluigi Poli, Andrea Zanini, Giovanna Pisi, Patrizia Pignatti, Mario Scuri, Alfredo ChettaAbstract:Inhaled therapy is often considered the cornerstone of asthma management and international guidelines recommend combination therapy of inhaled corticosteroids (ICS) and long-acting-beta2-agonists (LABA) in a large proportion of asthmatic patients. The effectiveness of ICS/LABA is dependent on the correct choice of device and proper inhalation technique, this influences drug delivery and distribution along the bronchial tree, including the most peripheral airways. The fixed combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) is the only extrafine formulation available in pressurized metered dose Inhaler (pMDI) and in dry powder Inhaler (DPI). Here, we focus on the recent significant advances regarding BDP/FF fixed combination for the treatment of asthma.
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inhaled beclometasone dipropionate formoterol fumarate extrafine fixed combination for the treatment of asthma
Expert Review of Respiratory Medicine, 2016Co-Authors: Ernesto Crisafulli, Gianluigi Poli, Andrea Zanini, Giovanna Pisi, Patrizia Pignatti, Mario Scuri, Alfredo ChettaAbstract:Inhaled therapy is often considered the cornerstone of asthma management and international guidelines recommend combination therapy of inhaled corticosteroids (ICS) and long-acting-beta2-agonists (LABA) in a large proportion of asthmatic patients. The effectiveness of ICS/LABA is dependent on the correct choice of device and proper inhalation technique, this influences drug delivery and distribution along the bronchial tree, including the most peripheral airways. The fixed combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) is the only extrafine formulation available in pressurized metered dose Inhaler (pMDI) and in dry powder Inhaler (DPI). Here, we focus on the recent significant advances regarding BDP/FF fixed combination for the treatment of asthma.
Ernesto Crisafulli - One of the best experts on this subject based on the ideXlab platform.
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Inhaled beclometasone dipropionate/formoterol fumarate extrafine fixed combination for the treatment of asthma
Expert Review of Respiratory Medicine, 2016Co-Authors: Ernesto Crisafulli, Gianluigi Poli, Andrea Zanini, Giovanna Pisi, Patrizia Pignatti, Mario Scuri, Alfredo ChettaAbstract:Inhaled therapy is often considered the cornerstone of asthma management and international guidelines recommend combination therapy of inhaled corticosteroids (ICS) and long-acting-beta2-agonists (LABA) in a large proportion of asthmatic patients. The effectiveness of ICS/LABA is dependent on the correct choice of device and proper inhalation technique, this influences drug delivery and distribution along the bronchial tree, including the most peripheral airways. The fixed combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) is the only extrafine formulation available in pressurized metered dose Inhaler (pMDI) and in dry powder Inhaler (DPI). Here, we focus on the recent significant advances regarding BDP/FF fixed combination for the treatment of asthma.
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inhaled beclometasone dipropionate formoterol fumarate extrafine fixed combination for the treatment of asthma
Expert Review of Respiratory Medicine, 2016Co-Authors: Ernesto Crisafulli, Gianluigi Poli, Andrea Zanini, Giovanna Pisi, Patrizia Pignatti, Mario Scuri, Alfredo ChettaAbstract:Inhaled therapy is often considered the cornerstone of asthma management and international guidelines recommend combination therapy of inhaled corticosteroids (ICS) and long-acting-beta2-agonists (LABA) in a large proportion of asthmatic patients. The effectiveness of ICS/LABA is dependent on the correct choice of device and proper inhalation technique, this influences drug delivery and distribution along the bronchial tree, including the most peripheral airways. The fixed combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) is the only extrafine formulation available in pressurized metered dose Inhaler (pMDI) and in dry powder Inhaler (DPI). Here, we focus on the recent significant advances regarding BDP/FF fixed combination for the treatment of asthma.
Alberto Papi - One of the best experts on this subject based on the ideXlab platform.
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inhaled beclometasone dipropionate formoterol extra fine fixed combination in the treatment of asthma evidence and future perspectives
Expert Opinion on Pharmacotherapy, 2008Co-Authors: Leonardo M. Fabbri, Gabriele Nicolini, Dario Olivieri, Alberto PapiAbstract:Background: Combinations of a long-acting β2-agonist (LABA) and an inhaled corticosteroid (ICS) are effective and safe options in asthma management. Objective: To review available data on a recently developed combination of beclometasone dipropionate (BDP) and formoterol (F) given via a pressurized metered-dose Inhaler. Methods: Published data on preclinical and clinical studies were reviewed. Results/conclusion: In the treatment of asthma, BDP/F was shown to be at least as effective and well-tolerated as other available combinations of ICS and LABA with the advantage of a better cost effectiveness, and more effective in improving asthma control than BDP and formoterol given via separate Inhalers. The extra-fine BDP/F combination appears to be a valuable therapeutic option in the management of asthma.
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rescue use of beclomethasone and albuterol in a single Inhaler for mild asthma
The New England Journal of Medicine, 2007Co-Authors: Alberto Papi, Dario Olivieri, Giorgio Walter Canonica, P Maestrelli, Pierluigi Paggiaro, Ernesto Pozzi, Nunzio Crimi, Antonio M Vignola, Paolo Morelli, Gabriele NicoliniAbstract:Background Treatment guidelines recommend the regular use of inhaled corticosteroids for patients with mild persistent asthma. We investigated whether the symptom-driven use of a combination of beclomethasone dipropionate and albuterol (also known as salbutamol) in a single Inhaler would be as effective as the regular use of inhaled beclomethasone and superior to the as-needed use of inhaled albuterol. Methods We conducted a 6-month, double-blind, double-dummy, randomized, parallel-group trial. After a 4-week run-in, patients with mild asthma were randomly assigned to receive one of four inhaled treatments: placebo twice daily plus 250 μg of beclomethasone and 100 μg of albuterol in a single Inhaler as needed (as-needed combination therapy); placebo twice daily plus 100 μg of albuterol as needed (as-needed albuterol therapy); 250 μg of beclomethasone twice daily and 100 μg of albuterol as needed (regular beclomethasone therapy); or 250 μg of beclomethasone and 100 μg of albuterol in a single Inhaler twice...
Gianluigi Poli - One of the best experts on this subject based on the ideXlab platform.
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Inhaled beclometasone dipropionate/formoterol fumarate extrafine fixed combination for the treatment of asthma
Expert Review of Respiratory Medicine, 2016Co-Authors: Ernesto Crisafulli, Gianluigi Poli, Andrea Zanini, Giovanna Pisi, Patrizia Pignatti, Mario Scuri, Alfredo ChettaAbstract:Inhaled therapy is often considered the cornerstone of asthma management and international guidelines recommend combination therapy of inhaled corticosteroids (ICS) and long-acting-beta2-agonists (LABA) in a large proportion of asthmatic patients. The effectiveness of ICS/LABA is dependent on the correct choice of device and proper inhalation technique, this influences drug delivery and distribution along the bronchial tree, including the most peripheral airways. The fixed combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) is the only extrafine formulation available in pressurized metered dose Inhaler (pMDI) and in dry powder Inhaler (DPI). Here, we focus on the recent significant advances regarding BDP/FF fixed combination for the treatment of asthma.
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inhaled beclometasone dipropionate formoterol fumarate extrafine fixed combination for the treatment of asthma
Expert Review of Respiratory Medicine, 2016Co-Authors: Ernesto Crisafulli, Gianluigi Poli, Andrea Zanini, Giovanna Pisi, Patrizia Pignatti, Mario Scuri, Alfredo ChettaAbstract:Inhaled therapy is often considered the cornerstone of asthma management and international guidelines recommend combination therapy of inhaled corticosteroids (ICS) and long-acting-beta2-agonists (LABA) in a large proportion of asthmatic patients. The effectiveness of ICS/LABA is dependent on the correct choice of device and proper inhalation technique, this influences drug delivery and distribution along the bronchial tree, including the most peripheral airways. The fixed combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) is the only extrafine formulation available in pressurized metered dose Inhaler (pMDI) and in dry powder Inhaler (DPI). Here, we focus on the recent significant advances regarding BDP/FF fixed combination for the treatment of asthma.
