Drug delivery from a Metered Dose Inhaler (MDI) / Spacer delivering triple therapy and self reported observations from COPD patients following the introduction of a Spacer

<bold>Objective:</bold> This lab study aimed to assess the drug delivery of a relatively new COPD triple therapy MDI with spacer, and seek feedback from COPD patients who were using MDIs with a specific spacer. <bold>Methods:</bold> Cascade Impactor testing was performed using Trimbow* beclomethasone dipropionate/formoterol fumarate/glycopyrronium bromide (BD/FF/GB 100/6/12.5 mcg/actuation) pMDI, delivered 0s after actuation, simulating perfect but unlikely coordination. A more realistic 2s delay (to simulate misuse) was investigated for MDI with Spacer (AeroChamber Plus* Flow-Vu* VHC). Patient feedback was received from 437 COPD patients in a voluntary UK/Canada database (MyAero*) comparing the main differences they experienced when using the Spacer with a pMDI compared to pMDI alone. <bold>Results:</bold> Fine Particle Mass (µg/actuation; mean+/-sd) and Fine Particle Fraction (%; mean+/-sd): <table-wrap><object-id>erj;66/suppl_69/PA350/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>pMDI alone</td><td>pMDI / Spacer</td></tr><tr><td>Delay (s)</td><td>0 (coordinated)</td><td>2 (uncoordinated)</td></tr><tr><td>FPM_BD</td><td>47.8 +/-0.8</td><td>44.7 +/-5.9</td></tr><tr><td>FPM_FF</td><td>2.4 +/-0.2</td><td>2.3 +/-0.5</td></tr><tr><td>FPM_GB</td><td>5.8 +/-0.1</td><td>5.7 +/-0.9</td></tr><tr><td>FPF_BD</td><td>51.5 +/-2.3</td><td>96.4 +/-0.4</td></tr><tr><td>FPF_FF</td><td>49.6 +/-3.6</td><td>100.0 +/-0.0</td></tr><tr><td>FPF_GB</td><td>50.5 +/-2.0</td><td>94.1 +/-1.5</td></tr></tbody></table></table-wrap> 79% of surveyed patients reported more confidence in medication delivery, 10% reported fewer emergency visits, and 10% reported less side effects. <bold>Conclusions:</bold> These results suggest that the Spacer tested can enable effective pMDI drug delivery, providing consistent delivery of the intended dose (even with poor coordination) and maximize fine particle delivery. The COPD patients surveyed provided positive feedback relating to confidence in medication delivery and some also reported less emergency visits / side effects.