Digital inhaler ‘is a great step forward’ in asthma treatment, presenter says
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HOUSTON — ProAir Digihaler, a multidose dry powder inhaler with built-in sensors that record information about its use and measure inspiratory flow, could dramatically change the course of asthma treatment, according to a presenter at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.
Each use of ProAir Digihaler (Teva Pharmaceuticals) provides a 90 g dose of albuterol, Roy Pleasants, PharmD, a clinical researcher at the University of North Carolina at Chapel Hill School of Medicine, told attendees.
Digihaler “provides clinicians a way to identify patients with poor asthma control and impending exacerbations, potentially in realtime if connected to a cloud service and health care provider via a clinical dashboard,” he said.
In a 12-week, open-label study of 64 patients aged 18 years and older, Pleasants and colleagues evaluated the patterns of albuterol use and inhalation parameters recorded on the ProAir Digihaler over a 14-day window around clinical asthma exacerbations (CAEs).
They found that during the 14-day window, patients had more daily albuterol inhalations than during exacerbation-free periods (mean, 2.43 vs. 1.87) and compared with patients without CAEs (mean, 1.14).
Patients with CAEs also had lower peak inspiratory flow (mean, 71.36 L/min vs. 74.71 L/min), similar inhalation volume (mean, 1.44 L vs. 1.44 L) and similar inhalation duration (mean, 1.61 seconds vs. 1.59 seconds) during the 14-day window compared with exacerbation-free periods, according to Pleasants.
“These data paint a novel picture of patients’ patterns of inhaled rescue medication use and inhalation parameters ... which is a great step forward with inhalers,” Pleasants said. “We’ve been pounding our heads on the walls for years, trying to get patients to use their inhalers. Now we have a tool that will be able to tell us if they’re using their inhaler or not and if they’re using it properly.”
ProAir is approved for patients aged 4 years and older and will be available by prescription in 2020, according to Teva Pharmaceutical.
Reference: Pleasants R, et al. Rescue medication use and inhalation patterns during asthma exacerbations recorded by ProAir Digihaler. Presented at: American College of Allergy, Asthma and Immunology Annual Scientific Meeting; Nov. 7-11, 2019; Houston.
Disclosures: Pleasants reports receiving grants from Boehringer Ingelheim and receiving personal fees from Grifols, Sunovion and Teva Pharmaceuticals. Please see the presentation for all other authors’ relevant financial disclosures.
Perspective
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Nabeel Farooqui, MD, FAAAAI, FACAAI
ProAir Digihaler is different than others in helping patients ensure they receive the correct amount of medication in several ways. Unlike currently available devices, which are add-ons that are attached to the top of the device, ProAir Digihaler’s electronic sensors and Bluetooth wireless technology are integrated directly into the inhaler. ProAir Digihaler also has the ability to not only track inhaler uses, but also measure inspiratory flow rates to determine if the user has inhaled sufficiently to receive the medication. This inhaler use data is then sent to the companion mobile app on the patient’s smartphone so they may review this information over time.
Despite their best efforts, patients with asthma may not always follow their treatment plan. These patients can opt to receive notifications from the companion mobile app for their maintenance AirDuo Digihaler to remind them to take their medication in accordance with their treatment plan.
Physicians should recommend ProAir Digihaler to their patients because the device is also able to measure inhalation flow rates and categorize inhaler events. Additionally, ProAir Digihaler tracks inhaler use and can help to identify when a patient uses a lot of their rescue inhaler or has challenges with inhalation technique, and alerts patients to talk to their health care provider. Patients can choose to share or review their inhaler use information with their doctors to help inform conversations about management of their condition.
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