| 1. Is Oxis effective as rescue medication? |
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Yes. Oxis has been shown to be as effective as salbutamol and more rapidly effective than salmeterol when used to treat methacholine-induced bronchoconstriction in patients with mild to moderate asthma (see figure below).(reference 4) Oxis Turbuhaler also produced a similar improvement in FEV1 as terbutaline Turbuhaler (Bricanyl) in patients with acute severe bronchoconstriction. (Reference19)
Rapid onset of action of Oxis in methacholine-induced acute bronchoconstriction in patients with mild to moderate asthma. Treatment with Oxis Turbuhaler led to an immediate relief of acute airway obstruction, shown here by an increase in FEV1 as fast as that with salbutamol Turbuhaler and significantly faster than with salmeterol Diskhaler®.(reference 4) |
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| 2. How does the efficacy of Oxis as needed compare with that of short-acting b2-agonists in clinical practice? |
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In a 12-week study in 362 patients who were receiving regular inhaled steroid treatment, Oxis Turbuhaler, 4.5 µg as needed, was more effective than terbutaline Turbuhaler (Bricanyl), 0.5 mg as needed. Asthma control was improved, the time to first asthma exacerbation was prolonged and the mean number of inhalations was lower in the Oxis group (see figure below).(reference 20)
In addition to these advantages of using Oxis as needed, patients using Oxis as maintenance therapy, would be able to control their asthma with only one bronchodilator instead of two, which will greatly simplify their treatment
As needed treatment with Oxis was more effective than terbutaline (Bricanyl) in patients receiving regular inhaled steroid. Oxis Turbuhaler, 4.5 µg, used as needed, reduces the number of rescue inhalations required, (p=0.0003), decreases the risk of having a severe exacerbation (p=0.013), improves lung function (p=0.0092), improves quality of life (p=0.0047) and is cost effective compared to as needed use of terbutaline Turbuhaler (Bricanyl®). (references 20, 21, 22) |
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| 3. Is Oxis as needed effective when the patient is already receiving regular maintenance therapy with Oxis? |
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Yes. Oxis is both effective and well-tolerated when used as needed for symptom relief by patients who are already receiving regular maintenance therapy with Oxis.(reference 23)
Additional doses of Oxis Turbuhaler, 9 µg, have also been shown to give significantly better protection against exercise-induced asthma than terbutaline Turbuhaler (Bricanyl), 0.5 mg or placebo when given to patients already receiving regular maintenance therapy with Oxis Turbuhaler. The protective effect of Oxis is evident within 15 minutes of administration and lasts for at least 12 hours.(reference 24) |
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| 4. What strength of Oxis should I use for as needed therapy? |
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| One of the advantages of using Oxis as needed is that the patients can use the same inhaler for reliever therapy as for maintenance therapy. You should therefore use the same strength that you use for regular treatment in the same patient, but remember to instruct the patient not to exceed the maximum daily dose. |
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| 5. What is the maximum dose a patient may take on a single occasion? |
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| The maximum recommended dose on a single occasion is 27 µg. This is well within the safety margin of the compound. (For more information click here) |
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| 6. Is the use of Oxis as needed cost-effective? |
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Yes. A recent study (reference 21) concluded that the use of Oxis Turbuhaler as needed is more cost-effective than terbutaline Turbuhaler (Bricanyl), and that it generates considerable overall cost savings from a societal perspective (see figure below). The number of severe exacerbations, which account for much of the cost of asthma treatment, was 43% lower in the Oxis group than in the terbutaline (Bricanyl) group.
Oxis as needed is cost-effective, as shown in this comparison of the total costs associated with 12 weeks of treatment with Oxis Turbuhaler or terbutaline Turbuhaler (Bricanyl) in 362 patients with moderate asthma (SEK =Swedish Crowns).(reference 21)
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| 7. Does Oxis as needed improve the patient's quality of life? |
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Yes. In a 12-week study in 362 patients the effects of Oxis Turbuhaler, 4.5 µg (delivered dose) as needed and terbutalineTurbuhaler (Bricanyl), 0.5 mg as needed, were compared.(reference 20) Astma specific quality of life (QoL) was assessed at monthly intervals in both groups of patients, using the Asthma Quality of Life Questionnaire. Mean QoL improved in both groups, but the improvement was significantly greater in the Oxis group (see figure below). (Reference 22)
Oxis as needed improves quality of life. Using the Asthma Quality of Life Questionnaire, improvement in quality of life (QoL) was noted in both treatment groups, but significantly more so in patients treated with Oxis than terbutaline (Bricanyl), (p=0.0047) (reference 22) |
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| 8. Is Turbuhaler an effective delivery device for rescue inhalation? |
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| Yes. Turbuhaler has been shown to achieve effective delivery of drug to the lower airways in patients with acute severe bronchoconstriction (reference 16, 17) and in those with severe COPD. (reference 18) |
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