Andrzej Emeryk, MD, PhD, from the Medical University of Lublin in Poland, and colleagues evaluated home monitoring of asthma exacerbations with the use of an AI-aided stethoscope. The analysis included 149 patients with asthma (90 children and 59 adults).

The researchers found that the best single-parameter discriminators of exacerbations were wheeze intensity for young children (area under the receiver operating characteristic curve [AUC], 84%), rhonchi intensity for older children (AUC, 81%), and survey answers for adults (AUC, 92%). The greatest efficacy was seen with a combination of several parameters.

“The AI-aided home stethoscope provides reliable information on asthma exacerbations. The parameters provided are effective for children, especially those younger than 5 years of age,” the authors write. “The introduction of this tool to the health care system might enhance asthma exacerbation detection substantially and make remote monitoring of patients easier.”

Several authors are employees of StethoMe Sp. z o.o., maker of the device used in the study.

Abstract/Full Text

Airsupra^® (albuterol/budesonide) is now available for the as-needed treatment or prevention of bronchoconstriction and to reduce the risk of exacerbations in patients with asthma 18 years of age and older.

Airsupra combines albuterol, a short-acting beta2-agonist, and budesonide, an inhaled corticosteroid. It is supplied as a metered dose inhaler containing 120 inhalations; each actuation delivers 90mcg of albuterol and 80mcg of budesonide. The canister has an attached dose indicator that shows how many inhalations are left in the product.

The approval of Airsupra was based on efficacy results in adult patients from two phase 3 trials: MANDALA (ClinicalTrials.gov Identifier: NCT03769090) and DENALI (ClinicalTrials.gov Identifier: NCT03847896). 

Findings from these studies showed the combination therapy significantly reduced the risk of severe asthma exacerbations vs albuterol alone in patients with moderate to severe asthma, and improved lung function compared with its individual components and placebo, in patients with mild to moderate asthma. The most common adverse reactions reported with treatment included headache, oral candidiasis, cough, and dysphonia.

The recommended dosage of Airsupra is albuterol 180mcg and budesonide 160mcg (administered as 2 actuations) as needed for asthma symptoms by oral inhalation. No more than 6 doses (12 inhalations) should be administered in a 24-hour period.

“With Airsupra now available in the US, we are taking an important step in our mission to revolutionize asthma for millions of people living with the disease,” said Liz Bodin, Vice President, US Respiratory & Immunology, AstraZeneca. “We are hopeful our innovative asthma rescue medicine can help alleviate the burden by addressing both symptoms and underlying inflammation simultaneously at the right time to reduce the risk of having a severe asthma attack.”

AstraZeneca is offering a copay assistance program for eligible patients. 

To determine whether asthma clinical remission (CR) could be attained with just inhaled therapy, researchers conducted a post hoc analysis of the phase 3 CAPTAIN trial (ClinicalTrials.gov Identifier: NCT02924688), which compared treatment with fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI) to fluticasone furoate and vilanterol (FF/VI) in adults with inadequately controlled asthma despite treatment with an inhaled corticosteroid/long-acting β2-adrenergic agonist. 

“CR was defined as no systemic corticosteroid use, no severe exacerbations, ACQ-5 total score ≤1.5, and change from baseline in trough FEV₁ ≥100mL,” the researchers explained. Assessments for CR were made at weeks 24 and 52 for the following dosages: FF/UMEC/VI 100/62.5/25mcg (n=406) or 200/62.5/25mcg (n=408) vs FF/VI 100/25mcg (n=407) or 200/25mcg (n=406). 

Results at week 24 showed 31% and 36% of patients treated with FF/UMEC/VI 100/62.5/25mcg or 200/62.5/25mcg achieved CR compared with 19% and 26% receiving FF/VI 100/25mcg or 200/25mcg. At week 52, CR was achieved by 30% and 38% of patients treated with FF/UMEC/VI 100/62.5/25mcg or 200/62.5/25mcg vs 21% and 24% receiving FF/VI 100/25mcg or 200/25mcg.

At week 24, a comparison of dosage showed that CR achievement was more likely with FF/UMEC/VI 100/62.5/25mcg vs FF/VI 100/25mcg (odds ratio [OR], 1.93 [95% CI, 1.39-2.68], P <.001; risk ratio [RR], 1.65 [95% CI, 1.29-2.12], P <.001). Similar results were seen when FF/UMEC/VI 200/62.5/25mcg was compared with FF/VI 200/25mcg (OR, 1.62 [95% CI, 1.19-2.19], P =.002; RR, 1.40 [95% CI, 1.13-1.72], P =.002).

Based on these findings the authors concluded that a greater proportion of patients achieved CR with the single inhaler triple therapy, adding that “CR is a feasible treatment goal for patients with moderate to severe asthma receiving FF/UMEC/VI and FF/VI.”

Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.