Previous real-world studies have found that a pressurized metered dosage inhaler (pMDI) had a lower risk of critical mistakes than a dry powder inhaler (DPI) and that ICS/LABA given by pMDI is more likely to achieve asthma control. In a real-world population in Kuwait, researchers assessed the acceptability, efficacy, safety, and cost-effectiveness of transitioning asthma patients from an ICS/LABA DPI to an ICS/LABA pMDI.

It was a prospective, 12-month observational, nonblinded research that took place in the actual world. Patients having asthma for at least a year and two or more asthma exacerbations in the previous year were given the option of switching to ICS/LABA pMDI or staying on ICS/LABA DPI. 

A total of 239 individuals were given either an ICS/LABA pMDI (Switch cohort; n=119) or an ICS/LABA DPI (Maintenance cohort; n=120) treatment. ICS/LABA pMDI was continued in the Switch cohort for the majority of patients (99/119; 83.2%) during a 12-month period. FEV1 levels improved in both cohorts, with the Switch group’s mean values approaching normal levels (>80% predicted). The Switch cohort had substantially higher FEV1 values than the Maintenance cohort at three and twelve months (P=0.001). The Switch group’s proportion of patients with managed asthma increased after 12 months, whereas the Maintenance groups did not alter appreciably. Switching from an ICS/LABA DPI to an ICS/LABA pMDI may improve asthma control in individuals with symptoms that are not adequately managed with an ICS/LABA DPI.