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Abstract
Inhaled corticosteroids (ICSs) are recommended for treatment of persistent asthma. Several ICSs are available and delivered by a variety of devices. After the banning of chlorofluorocarbon (CFC), a formulation of hydrofluoroalkane (HFA)-flunisolide marketed with an in-built spacer has been developed, complying with the request of efficacy and safety for children and adults. It delivers an aerosol with mass median aerodynamic diameter smaller than that of the CFC-formulation (1.2 vs 3.8 m). The extrafine aerosol and the add-on spacer are peculiarities of HFA-flunisolide with respect to the traditional ICSs, assuring larger lung deposition, lower oro-pharyngeal dose and targeting small airways. HFA-flunisolide with the spacer is effective at one-third the dose of CFC-flunisolide delivered without spacer. HFA-flunisolide may be considered an effective alternative to currently available ICSs for asthma management of adult and pediatric patients 6 years of age and older.
Financial & competing interests disclosure
The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues
The new formulation of flunisolide produces an extrafine aerosol (mass median aerodynamic diameter of 1.2 µm) and is marketed with an in-built spacer.
Proper use of hydrofluoroalkan (HFA) flunisolide assures high lung deposition and low oropharyngeal dose.
Extrafine HFA flunisolide delivered with the in-built spacer can contribute to reduce the risk of inhaler misuse.
Proper use of HFA flunisolide deliver with the spacer shows similar efficacy and safety at one-third the dose of chlorofluorocarbon flunisolide delivered without spacer.
Targeting the small airways, extrafine HFA flunisolide may help to improve asthma control and reduce healthcare utilization and costs.
When flunisolide is compared with other inhaled corticosteroid formulations for nebulization, it seems to offer some advantageous characteristics.