Am. J. Respir. Crit. Care Med., Volume 164, Number 2, July 2001, 256-259

Bronchodilation and Bronchoprotection in Asthmatic Preschool Children from Formoterol Administered by Mechanically Actuated Dry-powder Inhaler and Spacer

KIM G. NIELSEN and HANS BISGAARD

Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

We evaluated the bronchodilatory and the bronchoprotective effect of the long-acting ₂-agonist formoterol administered as dry powder from a mechanically actuated dry-powder inhaler (DPI) using spacer in 12 asthmatic children 2 to 5 yr of age. Lung function was measured as the specific airway resistance (sRaw) in a whole body plethysmograph. Hyperventilation of cold, dry air was used as bronchial challenge, and the responsiveness was estimated as change in sRaw. The bronchoprotective effect of formoterol Turbohaler 9 µg was compared with salbutamol 200 µg and placebo at 15 min, 4 and 8 h postdose in a randomized, double-blind, placebo-controlled, crossover study. All treatments were administered from DPI (Turbohaler) actuated mechanically into a spacer. Formoterol and salbutamol caused similar and significant bronchodilation at the first measurement 3 min postdose. Formoterol offered a sustained and stable bronchodilation for at least 8 h. Salbutamol provided significant bronchodilation for less than 4 h. Formoterol caused significant bronchoprotection of 80% for at least 8 h compared with placebo, and from 4 h onward compared with salbutamol. Bronchoprotection from salbutamol lasted less than 4 h. In conclusion, formoterol administered as dry powder in a single dose provided rapid and sustained bronchodilation and clinically significant bronchoprotection for at least 8 h in 2- to 5-yr-old asthmatic children. Furthermore, this study suggests that mechanical actuation of DPI using a spacer is effective for aerosol treatment of young asthmatic children.

Keywords: asthma; preschool children; long-acting ₂-agonist; automatic spacer; cold dry air challenge

This article has been cited by other articles:

				W. Lenney, A. L. Boner, L. Bont, A. Bush, K-H. Carlsen, E. Eber, B. Fauroux, M. Gotz, A. Greenough, J. Grigg, et al. Medicines used in respiratory diseases only seen in children Eur. Respir. J., September 1, 2009; 34(3): 531 - 551. [Abstract] [Full Text] [PDF]

				P. L. P. Brand, E. Baraldi, H. Bisgaard, A. L. Boner, J. A. Castro-Rodriguez, A. Custovic, J. de Blic, J. C. de Jongste, E. Eber, M. L. Everard, et al. Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach Eur. Respir. J., October 1, 2008; 32(4): 1096 - 1110. [Abstract] [Full Text] [PDF]

				M. N. Hermansen, K. G. Nielsen, F. Buchvald, J. J. Jespersen, T. Bengtsson, and H. Bisgaard Acute Relief of Exercise-Induced Bronchoconstriction by Inhaled Formoterol in Children With Persistent Asthma Chest, May 1, 2006; 129(5): 1203 - 1209. [Abstract] [Full Text] [PDF]

				H. Bisgaard and K. G. Nielsen Plethysmographic Measurements of Specific Airway Resistance in Young Children Chest, July 1, 2005; 128(1): 355 - 362. [Abstract] [Full Text] [PDF]

				K. G. Nielsen and H. Bisgaard Hyperventilation with Cold versus Dry Air in 2- to 5-Year-Old Children with Asthma Am. J. Respir. Crit. Care Med., February 1, 2005; 171(3): 238 - 241. [Abstract] [Full Text] [PDF]

				M. J. TOBIN Pediatrics, Surfactant, and Cystic Fibrosis in AJRCCM 2001 Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 619 - 630. [Full Text] [PDF]