Background: EU regulation on F-gases encourages physicians to treat patients with DPIs rather than pMDIs for environmental reasons. However, many fear this may worsen treatment outcomes.
Methods: and aim We performed a post-hoc analysis on clinical outcomes data from a 12-week real-world, non-interventional single arm study(1) of adult patients with asthma, COPD or asthma COPD overlap (ACO) who switched treatment from pMDI to DPI, budesonide-formoterol Easyhaler (B-F EH DPI), according to the treating physician and local guidelines. Clinical end points included ACT, CAT and lung function tests. Range of kg CO2e for one dose as reported in Montreal Protocol2 was used and as a conservative estimate, for lower range for B-F EH DPI, the average estimate reported (0.004 kg CO2e).
Results: Among all 253 patients, clinical improvements were observed after switch. Range of estimated kg CO2e emissions per year was (90-97%) lower for B-F EH DPI (2.9 ? 14.6 kg CO2e emissions/year) than for pMDI (91-137 kg CO2e emissions/year) assuming twice daily dosing for pMDI and B-F EH DPI.
| Asthma (n=142) | COPD (n=95) | ACO (n=16) | ||||
| baseline | 12 weeks | baseline | 12 weeks | baseline | 12 weeks | |
| ACT (mean) | 13.3 | 21.0* | 12.3 | 19.1* | ||
| CAT (mean) | 23.5 | 16.8* | 25.1 | 16.8* | ||
| FEV1% pred (mean) | 76.7 | 87.1* | 51.3 | 58.8* | 60.9 | 63.6** |
*p < 0.001; ** p =0.18
Discussion: The study shows that switching from a pMDI to B-F EH DPI may enhance disease control among patients with asthma, COPD and ACO and at the same time have a positive environmental impact by reducing the carbon footprint of inhaler treatment.
1. Tamasi L et al. Adv ther 2018;35:1140-52. 2. MCTOC 2018 Assessment Report p 32.