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We designed this study to assess efficacy of single-inhaler combination of an extra fine formulation of beclometasone dipropionate, formoterol fumarate, and glycopyrronium bromide (BDP/FF/GB) in COPD compared with beclometasone dipropionate and formoterol fumarate (BDP/FF) treatment.
Moreover, increasing the ratio of S/Co-S in the SMEF formulation resulted in more fine formulation and it was observed in all three S/Co-S ratios.
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(The alternative formulation replaces Stryrofoam with steel).
In an attempt to establish how treatment with inhaled extra-fine beclomethasone/formoterol (I-EF-BDP/F) formulation differs from other combinations of inhaled corticosteroid (ICS) and long acting beta-agonist (LABA), we studied lung function and markers of airway inflammation upon switching to the extra-fine formulation and after 8 weeks of treatment with it.
Regarding this work, Lichtenstein stated: Tøjner describes the work as "Lichtenstein's finest formulation of a counter-image to the many explosions in his universe", noting that the drama is past its peak although it may seem to be at a crescendo.
The effectiveness of the lower ICS dose in BDP/FF may be due to the extra-fine formulation that allows homogeneous distribution of the two drugs throughout the bronchial tree [ 31] entailing a greater efficacy per microgram of ICS, in agreement with previous studies on asthma [ 32- 34].
A four-fold molar excess of reducing agent in a fine granulated formulation with 46TiO2, pressures <5 × 10−3 mbar and temperatures of 950 1000 °C were identified to be crucial conditions to achieve maximum yields.
The extra fine beclometasone formulation has smaller particles than conventional inhaled glucocortiocosteroids and is possibly more effective.
With the aim of achieving the finest (nano)formulation, experimental parameters associated to these preparation procedures were analyzed.
The extra-fine BDP/FF formulation allows the treatment of both large and small airways; the latter are particularly relevant in COPD pathophysiology [ 35].
To understand the fine impacts of formulation, Monte Carlo simulations were performed on the Visco and Flex foam formulations, with urethane-urea catalysis ratio and water levels being varied within each foam series.
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