Effect of AeroChamber Plus™ on the lung and systemic bioavailability of beclometasone dipropionate/formoterol pMDI

Abstract

Aim: To assess the effect of AeroChamber Plus™ on lung deposition and systemic exposure to extra-fine beclometasone dipropionate (BDP)/formoterol (100/6 µg) pMDI (Foster®). The lung deposition of the components of the combination given with the pMDI was also evaluated using the charcoal block technique.

Methods: Twelve healthy male volunteers received four inhalations of extra-fine BDP/formoterol (100/6 µg) using (i) pMDI alone, (ii) pMDI and AeroChamber Plus™ and (iii) pMDI and charcoal ingestion.

Results: Compared with pMDI alone, use of AeroChamber Plus™ increased the peak plasma concentrations (C(max)) of BDP (2822.3 ± 1449.9 vs. 5454.9 ± 3197.1 pg ml(-1)), its active metabolite beclometasone 17-monopropionate (17-BMP) (771.6 ± 288.7 vs. 1138.9 ± 495.6 pg ml(-1)) and formoterol (38.4 ± 17.8 vs. 54.7 ± 20.0 pg ml(-1)). For 17-BMP and formoterol, the AUC(0,30 min), indicative of lung deposition, was increased in the AeroChamber Plus™ group by 41% and 45%, respectively. This increase was mainly observed in subjects with inadequate inhalation technique. However, use of AeroChamber Plus™ did not increase the total systemic exposure to 17-BMP and formoterol. Results after ingestion of charcoal confirmed that AUC(0,30 min) can be taken as an index of lung bioavailability and that more than 30% of the inhaled dose of extra-fine BDP/formoterol 100/6 µg was delivered to the lung using the pMDI alone.

Conclusions: The use of AeroChamber Plus™ optimizes the delivery of BDP and formoterol to the lung in subjects with inadequate inhalation technique. The total systemic exposure was not increased, supporting the safety of extra-fine BDP/formoterol pMDI with AeroChamber Plus™.

© 2011 CHIESI FARMACEUTICI SpA. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

Figures

Figure 1

(A) Beclometasone dipropionate (BDP) and (B) beclometasone 17-monopropionate (17-BMP) mean plasma profiles (standard deviation) after inhalation of four puffs extra-fine BDP/formoterol (100/6 µg) using pMDI alone (); pMDI + charcoal block (); pMDI + Aerochamber Plus ()

Figure 2

% Changes (median values) in the AUC(0,30 min) and AUC(0,tlast) for 17-BMP (A) and formoterol (B) after administration using the AeroChamber Plus™ compared with the pMDI alone in two groups of subjects: subjects with poor inhalation technique (low 50th percentile) and subjects with good inhalation technique (high 50th percentile). AUC (0, 30 min) (); AUC (0, tlast) ()

Figure 3

Formoterol mean plasma profile (standard deviation) after inhalation of four puffs extrafine BDP/formoterol (100/6 µg) using pMDI alone (); pMDI + charcoal block (); pMDI + Aerochamber Plus ()