Inhalers can come as: Metered-dose inhalers (MDIs), also called hydrofluoroalkane inhalers (HFAs) Dry powder inhalers (DPIs) The much less used Respimat, or soft-mist inhaler Differences between metered-dose inhalers and dry powder inhalers
The use of a pressurized metered-dose inhaler (pMDI) was found to have comparable efficacy and safety with that of a dry powder inhaler (DPI) in older patients with moderate to severe asthma, according to a study published in Allergy, Asthma & Immunology Research. . Metered dose inhalers are usually used as asthma rescue inhalers or reliever medicines 15087 Dft . Metered Dose Inhaler (MDI) and Dry Powder Inhaler (DPI) Products - Quality Considerations . Guidance for Industry . DRAFT GUIDANCE. This guidance document is being distributed for.
Metered dose inhalers (MDI) and dry powder inhalers (DPI) help you get the right amount of COPD medication when and where you need it. Get the tips you need from WebMD to use inhalers the right way The Metered-Dose Inhaler The Dry Powder Inhaler Clinical Applications What Is a Clinician to Do? Summary Inhaled drug delivery is an important part of the armamentarium of clinicians caring for patients with pulmonary disease. An increasing variety of metered-dose inhalers and dry powder inhalers are becoming available Soft mist inhalers are propellant-free devices that are slightly larger than conventional metered dose inhalers. These devices release a low-velocity aerosol mist that can be slowly inhaled over a longer period of time than metered dose and dry powder inhalers. Soft mist inhalers can be used with a valved holding chamber or a face mask in children
Metered dose inhalers (MDIs) Dry powder inhalers (DPIs) You may hear your provider refer to an inhaler as a preventer or reliever. These terms refer to the type of medication in the inhaler. A preventer inhaler helps prevent symptoms and exacerbations of COPD. They are used 1 or 2 times a day, at the same time for each dose dry powder inhaler (DPI) soft mist inhaler (SMI) Metered-dose inhaler. A metered-dose inhaler (MDI) is a handheld device that delivers asthma medicine to your lungs in aerosol form. The. Pressurized metered dose inhalers (MDIs) and dry powdered inhalers (DPIs) may be used in children older than 5 years of age. However, children are highly variable in their ability to use either.
They are called metered-dose inhalers (puffers), soft mist inhalers, and dry powder inhalers. Metered-dose inhaler. Soft mist inhaler. Dry-powder Inhaler. The reason for the variety is that different pharmaceutical companies have developed the different inhaled bronchodilators, all of which are patented for a period of time Metered dose inhalers. Portable and convenient. Non breath activated. More cost effective than dry powder inhaler. No preparation. Patient co-ordination essential. High pharyngeal deposition. Difficult to determine remaining doses. Breath actuated aerosol inhalers. Portable. Convenient. No co-ordination or high flow rate required. Limited range.
ELLIPTA Dry Powder Versus Metered-Dose Inhalers in an Optimized Clinical Trial Setting Inhaler technique can be optimized in trial settings. In such settings, ELLIPTA is associated with higher rates of correct use and lower error rates than are MDIs. Inhaler technique can be optimized in trial settings Topically inhaled bronchodilators and corticosteroids are the mainstay of treatment for asthma and chronic obstructive pulmonary disease. These medications are delivered via jet or ultrasonic nebulizer, metered-dose inhaler (MDI), or dry powder inhaler (DPI). While the number of devices may be confu However, dry powder inhalers are recently being seen as a good alternative because of some distinctive advantages. So if you're looking to switch from a metered dose inhaler (MDI) to a dry powder inhaler (DPI) and want to assess the advantages of them, then here is the list of dry powder inhaler advantages
Metered dose inhalers are the most common with asthma patients. Dry powder inhalers use capsules of dry powdered medicine. Depending on the type of DPI, users simply need to open, press, or twist their device to ready their medicine dose. Similar to MDIs, the user must place their mouth over the mouthpiece and inhale deeply and slowly Patients attended study visits on Days 1 and 28 of each period. Serial spirometry was assessed pre-dose and up to 12 h post-dose on Day 1 and up to 24 h post-dose on Day 28 of each treatment period, with data from the St. George's Respiratory Questionnaire (SGRQ) recorded pre-dose on both days The ELLIPTA inhaler device is associated with fewer critical and overall errors than are other dry powder or metered-dose inhalers. What does this article add to our knowledge? A significant proportion of participants demonstrated correct use of ELLIPTA and incorrect use of metered-dose inhalers versus the opposite outcome (87% vs 13% for both. Nebulizers, metered dose inhalers (MDIs), and dry powder inhalers (DPIs) have been competing in the marketplace for many years, and each has found a niche. While nebulizers have evolved relatively independently of the drug formulations that they deliver, MDIs and DPIs have necessarily been developed for their specific pharmaceuticals
ized metered-dose inhalers (pMDIs), nebulizers, and dry powder inhalers (DPIs). Similarly to ambulatory patients, aerosol delivery during mechanical ventilation also de-pends to a great extent on the type of aerosol-generating device employed. Only pMDIs and nebulizers have been adapted for clinical use during mechanical ventilation Metered Dose Inhaler (MDI) and Dry Powder Inhaler (DPI) Drug Products--Quality Considerations April 2018. Download the Draft Guidance Document Read the Federal Register Notice
It usually only takes a couple of minutes or less to give medication by metered dose inhaler with a spacer. Dry powder inhalers deliver medicine in powder form, but they don't spray out. The user must do more of the work, inhaling the powdered medicine quickly and quite forcefully. At around 5 or 6 years of age, most kids are able to do this You may have other inhalers that you use for different medicines. If one of them is a metered-dose inhaler (which sprays out a mist of liquid medicine), you might be using a spacer with it. But you should not use a spacer with a dry powder inhaler. Using a dry powder inhaler. Follow these steps for using a dry powder inhaler . The person must do more of the work by inhaling the powdered medicine quickly and deeply. Dry powder inhalers can be a little easier to use than metered dose inhalers, which are sometimes tricky
Metered-Dose Inhalers, Dry Powder Inhalers, and Transitions James B Fink MS RRT FAARC Introduction Pressurized Metered-Dose Inhalers Technique and Patient Education Pressurized Metered-Dose Inhaler Accessory Devices Flow-Triggered Pressurized Metered-Dose Inhaler Spacers and Valved Holding Chambers Wheezy Infants Care and Cleaning Dry Powder Inhalers Inspiratory Flow Why Dry Powder Inhalers. Dry powder inhalers are environmentally preferable to metered-dose inhalers. CMAJ 2020;192:E846-E846. Ismaila AS, Sayani AP, Marin M, Su Z. Clinical, economic, and humanistic burden of asthma in Canada: a systematic review Start studying RTH- 121 Metered Dose Inhalers (MDI) and Dry Powder Inhalers (DPI) (Module 3). Learn vocabulary, terms, and more with flashcards, games, and other study tools Pressurised metered dose inhalers (MDIs). Breath-activated inhalers - MDIs and dry powder inhalers. Inhalers with spacer devices. Nebulisers. The standard MDI inhaler. A standard MDI is shown above. The MDI has been used for over 40 years and is used to deliver various types and brands of medicines. It contains a pressurised inactive gas that. BAI - breath-actuated metered dose inhaler; DPI - dry powder inhaler; pMDI - pressurised metered dose inhaler * using multiple breath technique . Can you breathe in through your mouth quickly and deeply within 2 to 3 seconds? Can you breathe in through your mouth slowly and steadily ove
The main types of inhaler devices for asthma and COPD medicines are: Manually-actuated pressurized metered-dose inhalers (conventional puffer) e.g. Rapihaler, various generic names such as inhaler, CFC-free inhaler and metered aerosol. Breath-actuated pressurized metered-dose inhalers. e.g. Autohaler; Dry powder inhalers (multi-dose Metered-dose inhalers (MDIs) 3. Dry powder inhalers (DPIs) 5 6. Nebulizers Advantages: • High measurements of drug can be utilized • Multiple medications can be utilized as a part of single system • Requires less co-ordination of patient • Easy formulation handling Disadvantages: • Equipment is expansive which is hard to transport. There are three main methods of delivering respiratory drugs for most of the asthma patients metered dose inhaler (MDI), dry powder inhaler (DPI) and nebulizers. In case of dry powder inhalers (DPI) active pharmaceutical ingredient (API) powder with or without carrier (e.g. lactose) fine micronized particles are inhaled Deposition of Corticosteroid Aerosol in the Human Lung by Respimat® Soft Mist™ Inhaler Compared to Deposition by Metered Dose Inhaler or by Turbuhaler® Dry Powder Inhaler. Gary Pitcairn, Ph.D. Sandie Reader, Ph.D. Demetri Pavia, Ph.D. Steve Newman, Ph.D DRY POWDER INHALERS. Dry powder inhalers (DPIs) contain a dose of one or more medications in a dry powder form. DPIs deliver a fine powder to the lungs when you breathe in. With a DPI, you do not need to coordinate pressing the canister with inhaling. However, you must inhale more forcefully with a DPI than with a metered dose inhaler
• Metered - dose inhalers, dry powder inhalers and nebulizers are all types of devices that are used to dispense inhaled medicines. Each is used in a different way. • No matter which device you use, make sure you know how to use it correctly, so that the medicine works and your asthma is under control Dry Powder Inhalers to Attain New Benchmark The product segment is bifurcated into dry powder inhalers and meter dose inhalers (MDI). The dry powder inhaler (DPI) segment is projected to witness lucrative growth because of the growing prevalence of chronic respiratory diseases like COPD and asthma coupled with the growing demand for technology. Dry Powder Inhalers (DPI) This is the traditional type of inhaler, Metered-Dose Inhalers (MDI) This is the most commonly prescribed inhaler nowadays. This inhaler has the medication in the form of a liquid. They have pre-measured doses, may come with or without a dose counter, and release the medication in the form of a spray.. Dry powder inhalers do not require shaking; however, the patient must load the dose, exhale first away from the inhaler (ie, not into the dry powder), inhale with adequate inspiratory flow to ensure good pulmonary deposition, and hold the breath
The main types of inhaler devices are metered dose inhalers and dry powder inhalers. Metered dose inhalers Metered dose inhalers are also called MDIs or aerosol inhalers. The medicine is in a small canister, inside a plastic case. When the inhaler is pressed, a measured dose of medicine comes through the mouthpiece Metered dose inhalers (MDIs), dry powder inhalers (DPIs), and nebulizers are the popular modes of aerosol delivery. A spacer is an external device that is attached to an MDI to allow for better drug delivery by enhanced actuation and inhalation coordination.  The inherent advantages of aerosol drug delivery are a faster onset of pharmacologic action, because the drug is being delivered to. There are two main types of inhaler - dry powder inhalers and pressurised Metered Dose Inhalers (pMDIs). Wondering what type of inhaler you have? Find out here. If you have a pMDI, you need to breathe in slow and steady. At the same time, press the canister on the inhaler once. Continue to breathe in slowly over 3 to 4 seconds, until your. In an open randomised parallel-group study, 1004 patients with asthma in 7 countries were randomised to receive asthma treatment via 2 different kinds of inhalers: an aerosol pressurised metered dose inhaler (pMDI) and a dry powder inhaler (Turbuhaler)
Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J. 2002;19(2):246-251. 15. Khassawneh BY, Al-Ali MK, Alzoubi KH, et al. Handling of inhaler devices in actual pulmonary practice: metered-dose inhaler versus dry powder inhalers. Respir Care. 2008;53(3):324-328. 16 Three main types of inhaler devices are available: the pressurized metered dose inhaler (pMDI), the dry powder inhaler (DPI), and the soft mist inhaler (SMI) . Pressurized metered dose inhalers — pMDI devices consist of a pressurized canister, a metering valve and stem, and a mouthpiece actuator ( picture 1 ) Pressurized metered dose inhalers (MDIs) and dry powder inhalers (DPIs) are the most commonly used inhaler devices. MDIs, developed in the mid-1950s, 7 deliver a fixed drug dose from a pressurized canister requiring coordination between inhalation and actuation Different inhalers have distinct characteristics affecting drug administration and patient adherence, which can impact clinical outcomes. We report on the development of the Respimat ® soft mist inhaler (SMI) and compare key attributes with metered-dose inhalers (MDIs) and dry powder inhalers (DPIs). The Respimat SMI, a pocket-sized device.
Three types of dry powder inhalers: Turbuhaler, Accuhaler and Ellipta devices. DPIs are an alternative to the aerosol-based inhalers commonly called metered-dose inhaler (or MDI). The DPIs may require some procedure to allow a measured dose of powder to be ready for the patient to take . Respir Med 2008;102:593-604. doi: 10.1016/j.rmed.2007.11.003. Giraud V & Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J 2002;19:246-251. doi: 10.1183/09031936.02.0021840 The Borg score improved after treatment with both BDP/FF DPI and pMDI and the effect was greater than after placebo. Median time to reach 50% recovery was 4.2 min for BDP/FF DPI, 4.0 min for BDP/FF pMDI and 10.0 min for placebo (P = 0.609 DPI vs. pMDI). Conclusion
Nielsen KG, Auk IL, Bojsen K, Ifversen M, Klug B, Bisgaard H. Clinical effect of Diskus dry-powder inhaler at low and high inspiratory flow-rates in asthmatic children. Eur Respir J . 1998 Feb. 11. Inhalers send short bursts of aerosolized medication directly into the mouth and can work in seconds. However, some medication may be lost if the wrong technique is used. With a metered-dose inhaler, the mouthpiece has to be tightly sealed with the lips and inhaled while maintaining the seal . Dry powder inhalers were developed to overcome the difficulties of using metered dose inhalers, specifically the poor coordination of pressing the inhaler and inhaling the medicine, commonly known as Hand-Lung coordination. Using Dry powder inhalers, like any other aerosol devices may have its.
The test for Delivered-Dose Uniformity is required for inhalers (e.g., metered-dose inhalers or dry powder inhalers) containing drug formulation (e.g., solution, suspension, or powder) either in reservoirs or in premetered dosage units, and for drug formulations packaged in reservoirs or in premetered dosage units where these containers are labeled for use with a named inhalation device Using Metered-Dose or Dry Powder Inhalers (Steps and Rationals) STUDY. PLAY. Can the administration of inhaler medications be delegated to a NAP? The skill of administering inhaled medications and supervision of patients who self-administer them cannot be delegated to nursing assistive personnel (NAP) Metered Dose Inhalers (MDIs) Dry Powder Inhaler; Nebuliser; Metered Dose Inhalers (MDIs) are sometimes called aerosol inhalers. When the inhaler is pressed, a measured dose of medicine is released through the mouthpiece. It is recommended that MDIs are used with a spacer no matter what your age Metered-dose inhaler demonstration for nursing students and nurses using the open and closed mouth technique. Learn the proper technique on how to use a mete.. The number of puffs contained in a metered dose inhaler is printed on the side of the canister. Anti-inflammatory effects of inhaled steroids delivered by HFA-MDI vs delivery by dry powder.
The pharmacological treatment of chronic obstructive pulmonary disease (COPD) typically includes single or dual long-acting bronchodilators, with the primary goals of reducing symptoms and the risk of COPD exacerbations .Dual combinations of a long-acting muscarinic antagonist (LAMA) and a long-acting β 2-agonist (LABA) are a recommended treatment option for patients with severe. With a dry powder inhaler, powder is kept in individual chambers in extremely small amounts. The principal difference between a dry powder inhaler and a metered dose inhaler is that there is no press/squirt/inhale action. Instead, powder is kept in individual chambers in extremely small amounts I did some heavy editing of Inhaler, metered dose inhaler, and dry powder inhaler. I hope that suits the bunch.ThrustinJ 15:29, 1 August 2007 (UTC) Mixed oppose/support. My suggestion is that a new article asthma inhalent therapy is broken out of the asthma article as a see main article section. The new AIT article would offer more opportunity. Key words: albuterol; dry powder inhaler; metered-dose inhaler; e lative lung bioavailability inspiration. 6 Poor inhalation technique has been suggested to related reduced clinical effect. 7 Dry powder inhalers (DPis) were developed as a breath-actuated and environmentally friendly alter.
Metered dose inhalers, dry powder inhalers, and nebulizers are types of aerosol drug delivery primarily used to treat respiratory disorders. Metered dose inhalers are small devices that push a spray of medicine into the airways. Dry powdered inhalers also deliver medicine but the user must inhale deeply to allow the powdered drug to get into. Common types of inhalers are: Metered Dose Inhalers (MDI), Small Volume Nebulizer, Dry Powder Inhalers (DPI). A Metered-Dose Inhaler contains medication in a pressurized canister. To use the inhaler, take a deep breath as you push down on the canister, breathing in slowly for about 5 seconds. Hold for 10 seconds, before slowly releasing the breath DDU for Metered-Dose Inhalers (MDIs) & Breath-Actuated Inhalers (BAIs) The DDU is the total mass of drug emitted from the inhaler and hence available to the patient. Testing for uniformity ensures that the patient will receive the correct quoted amount be it from a single or multi-dose inhalers for the lifetime of the device Respimat inhalers are sometimes useful as an alternative to metered dose inhalers or dry powder inhalers. They use a watery mist, driven by a spring to propel medication into your lungs. Unlike metered dose inhalers they don't use environmentally damaging propellants and so have a small carbon footprin t Phase IV Study in Asthma Subjects for Dry Powder Inhaler (DPI) Versus (vs) Metered Dose Inhaler (MDI) Correct Use The safety and scientific validity of this study is the responsibility of the study sponsor and investigators
Some inhalers combine different sorts of medications, such as a steroid and long-acting bronchodilator. Most inhalers are either Metered Dose Inhalers (MDI) which contain HFA propellant, or Dry Powder Inhalers (DPI) which don't and therefore have far smaller carbon footprints Dry Powder Inhalers (DPI) Dry powder inhalers release a metered or device-measured dose of powdered medication that is inhaled through a DPI device. This device usually contains a chamber in which the powdered medication is deposited prior to each dosage. The powder can then be inhaled with a quick breath. This allows for medication to be delivered to the lungs without the need for use of. In this market report, TMR proposes that, the dry powder inhalers segment of the digital dose inhalers market is anticipated to expand at a high CAGR during the forecast period. Dry powder inhalers are drug delivery devices that are used to deliver the dry powder formulation of an active drug for systemic or local effects through a pulmonary route
The study is conducted to evaluate the potentially improved patient handling of the ELLIPTA Dry Powder Inhaler (DPI). Therefore, the study aims to evaluate errors encountered by subject with asthma during handling ELLIPTA DPI relative to two metered dose inhalers (MDI), a GSK MDI and the AstraZeneca (AZ) MDI The hydrofluorocarbon (HFC) propellants used today in pressurized metered-dose inhalers (pMDIs) have global warming potential (GWP) many times that of carbon dioxide. Their use, together with all other emissive uses of HFCs, is being phased down under the Montreal protocol. This has prompted calls to switch patients to dry powder inhalers (DPIs) Steroid Metered Dose Inhalers (MDIs) and dry powder inhalers (DPIs), such as Flovent and Pulmicort are used to prevent asthma, rather than treating the asthma once wheezing is present. Steroid MDIs and DPIs decrease inflammation and mucus production, decrease twitchiness of the airway and increase the effectiveness of other asthma medications Differentiating Dry Powdered Inhalers From Pressurized-metered Inhalers Dry powdered inhalers: This kind of inhaler doesn't need to be pumped or pressed to get the medication since it has dry powder. There is a simple device that helps to inhale the dry powder in a single deep breath, so the issue taking the wrong dosage does not come into play On April 18, 2018, FDA issued draft guidance on Metered Dose Inhaler (MDI) and Dry Powder Inhaler (DPI) Products—Quality Considerations. The guidance explains the chemistry, manufacturing, and controls (CMC) information that applicants should include in NDAs and ANDAs. The guidance updates and replaces the draft guidance from November 13, 1998
commercially available dry-powder inhalers. 18. Identify factors affecting the DPI performance and drug delivery. 19. Explain how you know that each DPI is empty. 20. List the correct steps for use of a nebulizer, metered-dose inhaler, metered-dose inhaler with holding chamber/spacer, and dry-powder inhaler. 21 Easyhaler® (Dry powder inhaler) Ellipta® (Dry powder inhaler) Genuair® (Dry powder inhaler) HandiHaler® (Inhalation powder, hard capsule) NEXThaler® (Dry powder inhaler) Metered dose inhaler® (MDI, aerosol) Respimat ®(Solution for inhalation) Spiromax® ( Dry powder inhaler) Turbohaler® (Dry powder inhaler) Aerochamber spacer ® 17. Metered dose and dry powder inhalers3 100-250 micrograms per day in 2 divided doses 300-500 micrograms per day in 2 divided doses 600-1,000 micrograms per day in 2 divided doses Fluticasone furoate4 Dry powder inhaler - 100 micrograms as a single daily dose 200 micrograms as a single daily dose
Metered Dose Inhaler Advantages. MDIs are the established, accepted form of treating the symptoms of asthma. There are a number of advantages to consider with metered dose inhalers, which can serve to help you appreciate why MDIs continue to be so popular: 1. Consistency: As the name implies, a metered dose inhaler works to give you a metered dose Inhaler devices. These include pressurised metered-dose inhalers, breath-actuated inhalers, and dry powder inhalers.Many patients can be taught to use a pressurised metered-dose inhaler effectively but some patients, particularly the elderly and children, find them difficult to use Respiratory Inhaler Identification Chart Short-acting Beta 2 Agonist Inhalers (SABAs) *MDI = metered dose inhaler Salbutamol MDI* ® (aerosol) Brands include: Airomir®, AirSalb ®, Salamol®, Ventolin Easyhaler® salbutamol (dry powder) Salamol ® Easi-Breathe salbutamol (aerosol) Clenil ® Modulite MDI* beclometasone (aerosol) Easyhaler. ICS inhalers have a small amount of corticosteroid medication that reduces inflammation in your bronchial tubes and ultimately open your airways to help you breathe easier. 1 These medications can be delivered through metered dose inhalers, dry powder inhalers, or through a nebulizer. When you breathe in your steroid inhaler medication, a small. metered dose inhaler (MDI), dry powder inhaler (DPI) and nebulizers. In case of dry powder inhalers (DPI) active pharmaceutical ingredient (API) powder with or without carrier (e.g. lactose) fine micronized particles are inhaled. The aggregates are converted into an aerosol by inspiratory airflow and thi
Using dry powder inhaler correctly is essential for getting your full asthma medication dosage Dry Powder Inhalers (DPIs) do not require the hand-breath coordination of a pressurized MDI. They are breath-actuated, meaning the medicine is released to your airways when you take a deep, fast breath from the inhaler ELLIPTA Dry Powder Versus Metered-Dose Inhalers in an Optimized Clinical Trial Setting Author links open overlay panel Edward M. Kerwin MD a Andrew Preece BSc(Hons) b Dimitra Brintziki MSc c Kathryn A. Collison MPH d Raj Sharma PhD Studies conducted in adults have suggested that patients who use a metered-dose inhaler/holding chamber spacer (MDI/S) and dry powder inhaler (DPI) concurrently will have poorer MDI/S technique than that of patients who use MDI/S exclusively. To our knowledge, as of August 31, 2006, no studies have been performed in pediatric patients
The test for Delivered-Dose Uniformity is required for inhalers (e.g.,metered-dose inhalers or dry powder inhalers)containing drug formulation (e.g.,solution,suspension,or powder)either in reservoirs or in premetered dosage units,and for drug formulations packaged in reservoirs or in premetered dosage units where these containers are labeled for use with a named inhalation device.(For. Metered Dose Inhalers (MDI) An MDI is the most common type of inhaler. It uses a press and breathe method which delivers a specific dose of medication in aerosol form Metered Dose Inhalers (MDIs) A metered dose inhaler is the type of inhaler doctors usually prescribe for teens. Dry Powder Inhalers. Like the name says, dry powder inhalers deliver medicine as a powder. The powder is also breathed in, but it doesn't spray out. You need to do more of the work by inhaling the powdered medicine quickly and.
A metered-dose inhaler is a handheld device that gives you a dose of medicine as a mist. You breathe the medicine deep into your lungs to open your airways. The medicine either gives quick relief or long term control of symptoms. Bronchodilators open your airways. Mucolytics thin secretions and make them easier to cough up pressurised metered-dose inhalers (pMDIs) breath-actuated metered dose inhalers (bMDIs) dry powder inhalers (DPIs, single or multidose), and; soft mist inhalers. Inhalers can contain either a single medication or a combination of medications. An inhaler can deliver: a bronchodilator, which helps to open up your airways and increase air flo The FDA previously approved a triple therapy dry powder inhaler called Trelegy Ellipta. The approval by the FDA was based on positive results from the Phase III ETHOS trial in which the triple combination showed a statistically significant reduction in the rate of moderate or severe exacerbations (flare-ups) compared with dual.