Effect of nasally exhaling budesonide/formoterol dry powder inhaled at "fast" inspiratory flow on eosinophilic chronic rhinosinusitis

• Published in: International journal of clinical pharmacology and therapeutics Vol. 56; no. 11; pp. 539 - 543
• Main Authors: Hamada, Satoshi, Hira, Daiki, Kobayashi, Yoshiki, Yasuba, Hirotaka
• Format: Journal Article
• Language: English
• Published: Germany Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG 01-11-2018
• Subjects: Administration, Inhalation; Adult; Aged; Asthma; Asthma - complications; Asthma - drug therapy; Bronchodilator Agents - administration & dosage; Bronchodilator Agents - therapeutic use; Budesonide - administration & dosage; Budesonide - therapeutic use; Chromatography; Drug Combinations; Dry Powder Inhalers; Eosinophils; Female; Forced Expiratory Flow Rates - drug effects; Formoterol Fumarate - administration & dosage; Formoterol Fumarate - therapeutic use; Humans; Inhalers; Male; Middle Aged; Patients; Respiratory therapy; Retrospective Studies; Rhinitis; Rhinitis - complications; Rhinitis - diagnostic imaging; Rhinitis - drug therapy; Sinuses; Sinusitis; Sinusitis - complications; Sinusitis - diagnostic imaging; Sinusitis - drug therapy; Tomography, X-Ray Computed
• ISSN: 0946-1965
• DOI: 10.5414/cp203272

Budesonide (BUD)/formoterol (FM) dry powder inhaler has a feature that the fine particle fraction output is dependent on users' inspiratory flow rate. The aim of this study was to assess the amount of nasally exhaled BUD/FM inhaled in the different inspiratory flow rate. We also examined the effect of nasal exhalation of BUD/FM dry powder inhaled on radiographic evidence of sinonasal inflammation in asthmatic patients with eosinophilic chronic rhinosinusitis (ECRS).
The quantitative amount of nasally exhaled BUD/FM was analyzed by high-performance liquid chromatography in 3 healthy subjects. We retrospectively evaluated the effect of nasal exhalation of BUD/FM dry powder inhaled at > 60 L/min on radiographic evidence of sinonasal inflammation, which was assessed according to the Lund-Mackay staging (LMS) system, in 7 consecutive patients with asthma and ECRS.
The amount of nasally exhaled BUD in the setting of inhaling BUD/FM dry powder inhaler at 60 L/min (subject 1: 25.8 ng/mL; subject 2: 37.3 ng/mL; subject 3: 30.0 ng/mL) was high compared to at 30 L/min (subject 1: 9.3 ng/mL; subject 2: 4.1 ng/mL; subject 3: 9.2 ng/mL) in each healthy subject. Nasal exhalation of BUD/FM dry powder significantly reduced total (p = 0.018) and ethmoid LMS scores (p = 0.0077).
Nasal exhalation technique of BUD/FM dry powder inhaled at "fast" inspiratory flow has a potential of simultaneously treating asthma and ECRS.
.