From the Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
Global Medical Affairs, Mylan Inc, Canonsburg, Pennsylvania; and.
Allergy Asthma Proc. 2021 Jan 21;42(1):30-35. doi: 10.2500/aap.2021.42.200112. Epub 2020 Dec 21.
A generic combination of fluticasone propionate and salmeterol xinafoate inhalation powder in a premetered, multidose, nonreusable inhaler was recently approved. To assess the performance of the generic device. Findings from three studies with regard to device usability, function, and robustness were reviewed. In a study to assess device function in patients and healthy volunteers, the generic device was successfully used by patients with asthma and chronic obstructive pulmonary disease who were either dry powder inhaler users or dry powder inhaler-naive, even though they were not trained beyond being provided the instructions for use. In a study to measure inhaled flow rates generated by patients and healthy volunteers, the generic device consistently simulated the delivery of a full dose of drug, even to patients with severe respiratory disease and reduced inspiratory flow rates. Although the generic device had a slightly higher airflow resistance, this study demonstrated that this difference did not result in any clinically meaningful differences in terms of drug delivery. Pressure drop, a key parameter that drives the fluidization and aerosolization of the powder dose, was found to be comparable between the devices. In an open-label study, the generic device met all U.S. Food and Drug Administration specifications for device robustness after 21.5 days of twice-daily dosing oral inhalation among 111 participants with asthma or chronic obstructive pulmonary disease. All inhalers tested demonstrated conformity with a pharmacopeia with respect to key quality parameters (assay, delivered dose uniformity, aerodynamic size distribution). There was no evidence of chemical degradation of the active ingredients, nor of microbial or water ingress into the powder, as a result of inhaler use.
一种丙酸氟替卡松和昔萘酸沙美特罗的通用复方吸入粉,以预充剂量、多剂量、不可重复使用的吸入器形式,最近获得批准。为了评估该仿制装置的性能,对三项关于装置易用性、功能和耐用性的研究结果进行了回顾。在一项评估患者和健康志愿者中装置功能的研究中,哮喘和慢性阻塞性肺疾病患者(包括干粉吸入器使用者和干粉吸入器初用者)成功使用了该仿制装置,尽管他们没有接受超出使用说明书之外的培训。在一项测量患者和健康志愿者吸入流速的研究中,该仿制装置始终如一地模拟了药物的全剂量输送,即使是呼吸功能严重受损且吸气流速降低的患者也是如此。虽然该仿制装置的空气流动阻力略高,但这项研究表明,这一差异并未导致药物输送方面的任何有临床意义的差异。推动粉末剂量流化和雾化的关键参数——压降,被发现两个装置之间具有可比性。在一项开放标签研究中,111 名哮喘或慢性阻塞性肺疾病患者在 21.5 天的每日两次剂量口服吸入后,仿制装置通过了美国食品和药物管理局对装置耐用性的所有规范要求。所有接受测试的吸入器均符合药典对关键质量参数(含量、递送剂量均匀性、空气动力学粒径分布)的要求。吸入器使用并未导致活性成分发生化学降解,也没有微生物或水进入粉末。