Clickhaler (a novel dry powder inhaler) provides similar bronchodilation to pressurized metered-dose inhaler, even at low flow rates

Study objective: Comparison of the bronchodilator response to an albuterol novel dry powder inhaler (DBI) (Clickhaler [CH]; hit Laboratories PLC; St. Albans, UK) activated at various inspiratory flow rates and to an albuterol pressurized metered-dose inhaler (pMDI) by patients with moderate to moderately severe stable asthma, Design: Randomized, double-blind, placebo-controlled comparison of the bronchodilator response to albuterol DPI (200 mu g) at: inspiratory flow rates of approximately 15, 30, and 60 L/min in patients with stable asthma with demonstrated reversibility to albuterol, Active (albuterol via pMDI inhaled at 30 L/min) and placebo controls were included. Setting: Single center study at the chest/allergy unit of a teaching hospital in Canada. Patients: Sixteen patients with moderate to moderately severe stable asthma. Measurements and results: Efficacy end points were FEV1, FVC, FEV1/FVC, maximum expiratory Row, and forced expiratory now between 25% and 75% of vital capacity. Safety end points included heart rate, BP, and tremor. There was no significant difference between the bronchodilator response to albuterol via the CH at 15, 30, and 60 L/min inspiratory now rate and, at all flow rates, no significant difference was found comparing albuterol CE-I with the pMDI, All of the techniques for delivering albuterol provided significantly better bronchodilatation than placebo. Adverse events were minimal and did not: differ between CW and pMDI or between the various flow rates inhaled through the CH, Conclusion: A novel passive albuterol DPI (CII) provides a similar bronchodilator response at 15, 30, and 60 L/min inspiratory flow rates compared with a pMDI used optimally.