"Smart" inhalers: is there a role in the management of severe asthma?

We report the utility of using "smart" inhaler technology to objectively address inhaled therapy in severe asthma patients who meet criteria for biologics.Methods: Consecutive consenting patients meeting criteria for biologics had their existing high-dose ICS/LABA//LAMA combination inhaler/s switched to mometasone/indacaterol/glycopyrronium (Enerzair® Breezhaler®). This inhaler comes with a sensor that connects via Bluetooth to an app, which records every inhaler use. Inhaler technique and the use of the app were taught, exhaled nitric oxide levels (FeNO) checked and ACQ-6 recorded at baseline. At 4 weeks adherence data and asthma control was reviewed; FeNO checked; a decision made whether to proceed to biologics; and follow up arranged.Results: Of the 46 patients (median age 49 [19-81], 15 male), 23 proceeded to biological treatment (Figure 1). Median FeNO and ACQ-6 score at baseline were 54 ppb and 3.08; and at 4 weeks were 38.5 ppb and 1.8 respectively. All patients had better asthma control at median follow up of 6 months.Summary: "Smart" inhalers may help in achieving better asthma control both by identifying sub-optimal adherence as well as due to ongoing monitoring of therapy.

Source: European Respiratory Journal - December 1, 2022 Category: Respiratory Medicine Authors: See, Y. Y., Chow, E. C. Y., Crooks, M., Robinson, M., Watkins, K., Turner, F., Thompson, J., Faruqi, S. Tags: 05.01 - Airway pharmacology and treatment Source Type: research