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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 beta 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 beta 2-agonist; automatic spacer; cold dry air challenge




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