Recently, chronic diseases that negatively affect the lungs and respiratory system such as asthma, chronic bronchitis, and chronic obstructive pulmonary (COPD) tend to increase due to environmental factors. Asthma and COPD cause excessive production of sticky material, which is described as mucus, wheezing, shortness of breath, and chest tightness 1. While most of the causes of this disease are tobacco exposure, air pollution, chemical gases, or dust, a very rare part of it occurs due to a genetic disease called alpha-1 antitrypsin deficiency (AATD) 2. According to the World Health Organization, it has been reported that COPD is the third leading cause of death worldwide and 3.2 million deaths were recorded in 2019 from COPD. According to the forecasts, it is predicted that COPD will rise to the 3rd place among the diseases that result in death by 2030 3.
In the treatment of such diseases, many different inhalation products, such as dry powder inhalations (DPIs), nebule, and pressurized metered dose inhalers (MDIs), are used to provide local and systemic treatments to reduce inflammation in the respiratory system and increase airflow 4, 5. DPIs have become popular medical drugs due to their ease of use for patients, the absence of propellants, and the ability to quickly deliver small amounts of API to the patient orally 6,7. However, it is known that DPI products are sensitive to relative humidity (RH) and electrostatic charge, and the aerodynamic distribution in the lung is affected 8. DPIs must be protected from the external environment to protect them from relative humidity 9. For this reason, different humidity protection products are used by manufacturers, and desiccants can also be used in packaging 10.
In dry powder inhalation products, it is not important the amount of the active substance contained in the unit dose, it is important the amount of the active substance reaching the patient by inhalation. The effectiveness of DPIs is demonstrated by their ability to deliver reproducible fine particle doses (FPDs) of a given inhalable API to the site of action in the respiratory tract. Similarly, FPD can be defined as the dose of an aerosolized drug with a particle size < 5 µm 11.
Mass median aerodynamic diameter (MMAD) and geometric standard deviation (GSD) parameters affect the deposition of inhaled particles. Particles with an aerodynamic diameter of 0.5 to 5 µm are more likely to accumulate in the lung, whereas smaller particles can penetrate deeper into the lungs 12. The increase in the spread of the aerodynamic diameters of the particles depends on the high GSD value. The total dose is the amount of drug recovered from all parts (mouthpiece, induction port, pre-separator, NGI stages) used during analysis 13.
In the study of Borgstrom et al., fluticasone propionate/salmeterol Accuhaler and budesonide/formoterol Turbuhaler were studied at different relative humidity conditions, and it was shown that their FPD was affected 14. O'Callaghan et al. showed in their study that the electrostatic charge in inhaler devices made up of plastic materials causes the drug to be retained in the device 15.