Metered-Dose Inhalers for Delivering Inhaled Steroids and β₂-Agonists

There are numerous ways to deliver inhaled corticosteroids or β₂-agonists to patients with asthma. Such devices vary in method and price, but do they vary in effectiveness? In 2 systematic reviews, researchers investigated whether any other inhaler was better than a metered-dose inhaler (MDI).

In the first analysis, 29 randomized controlled trials were identified that involved children or adults with asthma. In all studies, handheld, pressurized, chlorofluorocarbon-containing MDIs were compared with other handheld devices (dry-powder inhalers, hydrofluoroalkane-pressurized inhalers, and breath-actuated pressurized inhalers) that delivered the same inhaled corticosteroid. In adjusted analyses, no differences were found between MDIs and other …