Comparison of bronchodilator response between Dosivent® and Aerochamber Plus® Flow-Vu® chambers in patients with bronchial hyperreactivity

Abstract

Background: Aerochambers are used for the administration of inhaled drugs. Dosivent ® is a previously unstudied chamber. This study aimed to validate the Dosivent ® chamber against the widely used Aerochamber Plus ® Flow-Vu ® . Methods: We conducted a non-randomized, open-label, cross-over-controlled, and clinical trial (NCT05821868) in 50 patients with a known positive bronchodilator test. Bronchodilator washout was performed according to standard recommendations. Fifteen minutes after the administration of 400 µg of salbutamol with either chamber, the changes in forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) were measured. The agreement was measured by the intraclass correlation coefficient and Bland-Altman graphical analysis. Participants' satisfaction with the chamber was assessed with the FSI-10 questionnaire. Results: The mean participant age was 58.0 (SD = 18.5) years, half were women, and only 31 (62%) participants had an FEV1/FVC of <0.7. The median increases in FEV1 obtained with the Aerochamber Plus ® Flow-Vu ® and Dosivent ® were 0.28 L (interquartile range [IQR]: 0.21 -0.38) and 0.29 L (IQR: 0.20 -0.43), respectively, and the median increases in FVC were 0.29 L (IQR: 0.19 -0.37) and 0.28 L (IQR: 0.19 -0.45). The intraclass correlation coefficient for increases in FEV1 was 0.865, and it was 0.820 for increases in FVC. The median FSI-10 questionnaire score was 42 (IQR: 37 -47) with Aerochamber Plus ® Flow-Vu ® and 44 (39 -48) with Dosivent ® (P < 0.001). Conclusions: Our study revealed a strong agreement between salbutamol responses when utilizing both the Dosivent ® and Aerochamber Plus ® Flow-Vu ® chambers. This suggests that these devices are interchangeable and can be effectively employed in routine clinical practice. Relevance for Patients: For patients using inhaled medications, this study provides reassurance regarding the equivalence of the Dosivent ® chamber with the widely used Aerochamber Plus ® Flow-Vu ® . This provides patients with more options for device selection, potentially improving convenience and satisfaction with their inhalation therapy. Patients and healthcare providers can consider the Dosivent ® chamber as a viable alternative, which may positively impact treatment adherence and overall respiratory health management.