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In Vitro Performance of Valved Holding Chambers in Paediatric Asthma Controller Therapy
Laura Ojanperä1, Lauri Lehtimäki2,3, Péter Csonka1
1Tampere Center for Child, Adolescent and Maternal Health Research Tampere University, Tampere, Finland.
Acta Paediatrica (Oslo, Norway : 1992)
|June 2, 2026
Summary
Valved holding chambers (VHCs) show varied drug delivery for inhaled corticosteroids in children. EasyChamber demonstrated superior fine particle delivery for combination inhalers and ciclesonide compared to other VHCs.
Area of Science:
- Pharmacology
- Respiratory Medicine
- Drug Delivery Systems
Background:
- Limited research exists on inhaled corticosteroid and combination medication delivery via valved holding chambers (VHCs) using pediatric breathing patterns.
- Optimizing VHC performance is crucial for effective asthma management in children.
Purpose of the Study:
- To evaluate the in vitro performance of commercially available VHCs without facemasks under preschooler breathing conditions.
- To compare the total delivered dose and fine particle dose (FPD) of different inhaled medications across various VHCs.
Main Methods:
- Three VHCs (AeroChamber Plus Flow-Vu, EasyChamber, OptiChamber Diamond) were tested with fluticasone/salmeterol, fluticasone propionate, and ciclesonide inhalers.
- Drug delivery was assessed using a Next Generation Impactor with simulated breathing patterns of a 4-year-old child.
- Fine particle dose (FPD) in the 1-5 μm range was a primary outcome measure.
Main Results:
- Ciclesonide showed the highest total delivered dose across all tested VHCs.
- EasyChamber significantly improved the median FPD (1-5 μm) for both combination inhaler components (salmeterol, fluticasone) and ciclesonide compared to AeroChamber and OptiChamber.
- Relative throat deposition was lowest for ciclesonide and highest for fluticasone mono-inhaler, with specific VHCs showing advantages for certain medications.
Conclusions:
- Significant differences in drug delivery performance were observed among the tested VHCs.
- Ciclesonide demonstrated more favorable aerodynamic properties compared to fluticasone when delivered via VHCs.
- The choice of VHC can impact the efficiency of inhaled medication delivery in young children.
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