A Randomized, Double-Blind Crossover Study of Change in Post-Dose Lung Function with Hydrofluoroolefin-1234ze, a Next-Generation Propellant for Metered Dose Inhalers, in Participants with Asthma.

IF 2 4区 医学 Q3 RESPIRATORY SYSTEM
Roy A Pleasants, Alan S Bell, Mandeep Jassal, John Xu, David Petullo, Ibrahim Raphiou, Magnus Aurivillius, Patrik Bondarov, Mehul Patel
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引用次数: 0

Abstract

Background: Pressurized metered dose inhalers (pMDIs) currently contain propellants with relatively high global warming potential (GWP), such as hydrofluoroalkane-134a (HFA-134a). Hyrofluoroolefin-1234ze (HFO-1234ze) is a near-zero GWP propellant in development for use in future pMDIs. Methods: This Phase IIIb, multicenter, randomized, double-blind, single-dose crossover study aimed to assess post-dose lung function and clinical manifestations of bronchospasm following single doses of HFA-134a and HFO-1234ze via pMDI (four inhalations with no active drugs) in participants with well or partially controlled asthma. The primary endpoint was change from baseline in forced expiratory volume in one second area under the curve from 0 to 15 minutes (FEV1 AUC0-15 minutes) post-dose and was assessed using a linear mixed-effect model. Secondary endpoints included cumulative incidence of bronchospasm events (reduction in FEV1 of >15% from baseline at 5 or 15 minutes post-dose with associated wheezing, shortness of breath, or cough). Safety and tolerability were also assessed. Results: Among 52 participants randomized to treatment, noninferiority of HFO-1234ze pMDI versus HFA-134a was established for change from baseline in FEV1 AUC0-15 minutes post-dose between treatments (least squares mean [LSM]; 95% confidence intervals [CI] change: HFO-1234ze pMDI, -0.014 [-0.033, 0.006] L; HFA-134a, -0.004 [-0.024, 0.015] L; LSM [95% CI] difference: -0.009 [-0.037, 0.018; p = 0.492]). No bronchospasm events were reported. Two patients (3.8%) in each group experienced ≥1 adverse event (AE). No serious AEs, AEs of special interest, or AEs leading to discontinuation were reported. Conclusions: HFO-1234ze pMDI was well tolerated in participants with well or partially controlled asthma. As with HFA-134a pMDI, no significant effects on lung function or bronchospasm events were observed. As HFO-1234ze pMDI has a near-zero GWP, it represents a compelling, environmentally conscious alternative propellant for use in pMDI devices for treatment of chronic respiratory disease. Trial Registration: NCT05850494.

新一代计量吸入剂推进剂氢氟烯烃-1234ze对哮喘患者给药后肺功能变化的随机双盲交叉研究
背景:加压计量吸入器(pmdi)目前含有具有较高全球变暖潜能值(GWP)的推进剂,如氢氟烷烃-134a (HFA-134a)。氢氟烯烃-1234ze (HFO-1234ze)是一种接近零GWP的推进剂,正在开发中,用于未来的pmdi。方法:本IIIb期、多中心、随机、双盲、单剂量交叉研究旨在评估经pMDI(4次无活性药物吸入)单剂量HFA-134a和HFO-1234ze后支气管痉挛的肺功能和临床表现。主要终点是给药后0-15分钟曲线下一秒区域用力呼气量(FEV1 AUC0-15分钟)与基线相比的变化,并使用线性混合效应模型进行评估。次要终点包括支气管痉挛事件的累积发生率(在给药后5或15分钟,FEV1较基线减少150 %,并伴有喘息、呼吸短促或咳嗽)。安全性和耐受性也进行了评估。结果:在随机分配到治疗组的52名参与者中,HFO-1234ze pMDI与HFA-134a在治疗后0-15分钟的FEV1从基线变化的非劣效性被确立(最小二乘平均值[LSM];95%置信区间[CI]变化:HFO-1234ze pMDI, -0.014 [-0.033, 0.006] L;HFA-134a, -0.004 [-0.024, 0.015] L;LSM [95% CI]差异:-0.009 [-0.037,0.018;P = 0.492])。无支气管痉挛事件报道。每组均有2例(3.8%)患者出现≥1次不良事件(AE)。未见严重不良反应、特殊利益不良反应或导致停药的不良反应报告。结论:HFO-1234ze pMDI在哮喘控制良好或部分控制的受试者中耐受性良好。与HFA-134a pMDI一样,未观察到对肺功能或支气管痉挛事件的显著影响。由于HFO-1234ze pMDI的全球变暖潜能值接近于零,它代表了一种令人信服的、具有环保意识的替代推进剂,可用于治疗慢性呼吸道疾病的pMDI装置。试验注册:NCT05850494。
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来源期刊
CiteScore
6.70
自引率
2.90%
发文量
34
审稿时长
>12 weeks
期刊介绍: Journal of Aerosol Medicine and Pulmonary Drug Delivery is the only peer-reviewed journal delivering innovative, authoritative coverage of the health effects of inhaled aerosols and delivery of drugs through the pulmonary system. The Journal is a forum for leading experts, addressing novel topics such as aerosolized chemotherapy, aerosolized vaccines, methods to determine toxicities, and delivery of aerosolized drugs in the intubated patient. Journal of Aerosol Medicine and Pulmonary Drug Delivery coverage includes: Pulmonary drug delivery Airway reactivity and asthma treatment Inhalation of particles and gases in the respiratory tract Toxic effects of inhaled agents Aerosols as tools for studying basic physiologic phenomena.
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