The impact of actuation and inhalation coordination of pMDI on lung deposition via FRI

<bold>Background:</bold> pMDIs are used for the delivery of respiratory medications in several diseased groups. Coordinating their actuation with patient's inhalation is important for maximizing therapeutic efficacy and minimizing deposition in the oropharyngeal region. <bold>Objectives:</bold> This study aims to explore the impact of actuation coordination with patients' inhalation on lung deposition of 5 asthma patients. <bold>Methods:</bold> Lung deposition of inhaled medications via extra-fine ICS/LABA formulation pMDI is evaluated utilizing Functional Respiratory Imaging (FRI). The study comprises five moderate asthma patients (3 male, 2 female) with an average FEV1% of 108.5%. All patients are subjected to an inhalation profile featuring a mean flow of 30 l/min. Two simulation sets are conducted: one with actuation at the onset of inhalation (0 s) and another with a 0.5 s delay. <bold>Results:</bold> Intrathoracic deposition averages at 41.2% of the delivered dose with coordinated actuation, decreasing to 36.9% with a 0.5 s actuation delay (Figure 1). A similar trend is observed in peripheral deposition, with approximately 32.54% and 27.94% deposition, respectively. <bold>Conclusions:</bold> When educating patients on pMDI use, stressing inhalation-actuation synchronization is vital for optimal outcomes. This study suggests triggering actuation after inhalation initiation may deposit more medication in upper airways than achieving deeper lung deposition. <fig><object-id>erj;64/suppl_68/PA2113/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> Figure 1.