3030 Safety and Inhaler Use with Mometasone Furoate Delivered Via Dry Powder Inhaler for Children with Persistent Asthma

Tuesday, 6 December 2011
Poster Hall (Cancún Center)

Robert Berger , Device Development, Merck Research Laboratories, Summit, NJ

Ariel Teper, MD , Allergy/Respiratory, Merck Research Laboratories, Summit, NJ

Jorge Moreno-Cantu, M.Sc., PhD , Office of the Chief Medical Officer, Merck & Co., Kenilworth, NJ

David Skoner, MD , Department of Pediatrics, West Virginia University School of Medicine, Philadelphia, PA

Background: Inhaled corticosteroids (ICSs) are the most effective controller therapy for children of all age groups with persistent asthma. Safety of ICSs with regard to growth effects in children and ease of using ICS inhaler devices properly are 2 concerns in treatment selection. Mometasone furoate delivered via a dry powder inhaler (MF-DPI, Merck & Co., Inc.) 110 µg once-daily (QD) in the evening is an ICS approved for use in children aged 4-11 years. In addition to efficacy, we assessed the safety of MF-DPI and the ease of use of the inhaler when administered once daily from on-label pediatric studies.

 

Methods: Growth rate data were collected in a randomized, 1-year study that evaluated MF-DPI 110 µg twice-daily (BID), MF-DPI 220 µg and 110 µg (both QD morning doses), and placebo in 187 children (4-9 years) with asthma (previously maintained on inhaled beta-agonists). Peak inspiratory flow rate (PIFR) data were collected in an in vivo study of PIFRs and airflow profiles through a functional model of the MF-DPI in 55 children (5-12 years) with mild persistent asthma.

 

Results: Mean growth rates for MF-DPI 110 µg BID, 220 µg QD, 110 µg QD, and placebo were 5.34, 5.93, 6.15, and 6.44 cm/y, respectively. The difference in growth rates (95% CI) between active drug and placebo for MF-DPI 110 µg BID, 220 µg QD, and 110 µg QD were -1.11
(-2.34, 0.12), -0.51 (-1.69, 0.67), and -0.30 (-1.48, 0.89), respectively. The mean PIFR through the MF-DPI for children aged 5-8 years was >50 L/min (minimum, 46 L/min) and for children aged 9-11 years was >60 L/min (minimum, 48 L/min). All of the measured rise times (rapidity of inhalation) were lower than the maximum rise time (300 msec) shown in vitro to provide delivery of respirable particles.

 

Conclusions: Study evidence shows that MF-DPI has negligible growth effects and that children are able to use the inhaler properly to achieve drug delivery to the lungs. The characteristics of MF-DPI indicate it is a valuable treatment option for children with asthma.