Some people with asthma need to use multiple inhaled medicines daily to keep their symptoms under control. New long-acting inhalers that contain more than one medicine are simplifying asthma treatment. Instead of using several different inhalers multiple times per day, many people are now able to use only one inhaler each day to keep their symptoms under control.
One of these new inhalers that contains a combination of long-acting medicines is called Breztri Aerosphere. It contains three different medicines to treat asthma. You may hear this called “triple therapy.” Managing asthma can be challenging, especially when your current medicines are not keeping your symptoms under control. Breztri is a single inhaler that combines three medicines to help make breathing easier, so you can focus on living your life.
Continue reading to learn more about using Breztri for asthma, including how it works, how to use the inhaler, and the benefits of using Breztri for asthma.
How Does Breztri Aerosphere Work for Asthma?
Asthma is a long-term (chronic) condition of the lungs that can make it hard to breathe. Airways can get narrowed from swelling (inflammation) and because the muscles in the airways tighten up. This swelling and tightness can make your airways very irritated and sensitive. The airways can also become clogged with mucus.
The key to treating asthma is to reduce the amount of swelling and tightness in the lungs. This helps make it easier to breathe. It also makes the lungs less sensitive to triggers, which can reduce the number of asthma attacks, including coughing, wheezing, difficulty breathing, and tightness or pain in the chest.
Breztri has three different medicines in one inhaler: budesonide, formoterol fumarate, and glycopyrrolate. Together, these medicines reduce swelling and relax the muscles in your airways to make it easier for you to breathe.
- Budesonide is an inhaled corticosteroid (ICS). It reduces swelling in your airways, helps make it easier to breathe, and reduces coughing.
- Formoterol fumarate is a long-acting beta-2 agonist (LABA). It helps the muscles in your airways relax.
- Glycopyrrolate is an anticholinergic medicine. You may also hear it called a long-acting muscarinic agent (LAMA). It also relaxes the muscles in your airways.
Formoterol and glycopyrrolate are both bronchodilators and work in different ways to relax the muscles in your airways. This helps reduce wheezing, coughing, chest tightness, and shortness of breath.
Note that Breztri Aerosphere is not a rescue inhaler. It is not meant to provide quick relief during an asthma attack or sudden breathing problems. People using Breztri for asthma should keep a rescue inhaler available and seek medical care if symptoms worsen or do not improve.
How Was Breztri Aerosphere Studied for Asthma?
Two large studies (KALOS and LOGOS) were done to evaluate Breztri to treat asthma. These studies included adults and children who were 12 years or older with asthma who were not well controlled on their current asthma medicines. Both studies compared Breztri with inhalers containing two of the medicines in Breztri, budesonide and formoterol fumarate (BFF). Neither the researchers nor the study participants knew who was using Breztri and who was using BFF. If a person had sudden trouble breathing, they were told to use their rescue inhaler.
Participants had similar scores when comparing lung function and overall asthma control. Below is a summary of the participants’ characteristics before starting the studies.
KALOS | LOGOS | |
|---|---|---|
| Average age | 52 (range, 12-80 years) | 52 (range, 12-80 years) |
| Female/male | 63%/37% | 61%/39% |
| Race and ethnicity | White: 65% Asian: 24% Black or African American: 2% American Indian or Alaska Native: ~1% Other: 8% Hispanic/Latino: 30% | White: 45% Asian: 38% Black or African American: 6% American Indian or Alaska Native: 1% Other: 10% Hispanic/Latino: 12% |
| Time since diagnosis of asthma | ~16 years, ranging from 1 to 74 years | ~15 years, ranging from 1 to 76 years |
The main goal of the study was to compare the change in lung function. Lung function was measured by how much air participants could forcefully exhale, both shortly after using the medicine and first thing in the morning before their next dose.
The studies also looked at the number of severe asthma attacks and overall asthma control using a survey. A severe asthma attack was defined as one that required steroid treatment, urgent care or emergency room treatment, a hospital stay, or resulted in death.
What Benefits Were Seen?
The main goal of both studies was to see how much lung function improved after six months of treatment. Both studies showed that participants using Breztri were able to breathe more easily than those using BFF, meaning their lungs were able to move more air, especially over the first few hours after using the inhaler. The table below shows the specific results.
| Study | KALOS | LOGOS | ||
|---|---|---|---|---|
| Treatment groups | Breztri | BFF | Breztri | BFF |
| Average change* from baseline at 24 weeks, shortly after using the inhaler (mL of air) | 316 | 249 | 354 | 219 |
| Difference between groups | 68 | 134 | ||
| Average change* from baseline at 24 weeks, first thing in the morning before using the inhaler | 157 | 115 | 177 | 69 |
| Difference between groups | 42 | 107 | ||
*Higher numbers indicate a larger improvement in lung function.
After six months, the study results showed no significant difference in severe asthma attacks between Breztri and BFF, with similar rates in both treatment groups.
In addition, participants completed a survey about how well their asthma was controlled after six months of treatment. In both studies, about two-thirds of participants reported improvement in their asthma control. In KALOS, 65% of Breztri users improved compared with 64% of BFF users. In LOGOS, the figures were 68% and 64%, respectively. Overall, the results were similar for both groups, indicating similar asthma control with either treatment. The results were very similar between the two groups, indicating similar asthma control with either treatment.
In summary, Breztri seemed to allow participants to breathe a little easier and move more air out of their lungs than BFF. It showed similar results to BFF in terms of severe asthma attacks and asthma control surveys after six months of treatment. Keep in mind your results may differ from what was seen in these studies.
How Do I Use Breztri Aerosphere?
Before using Breztri, make sure your health care provider has taught you how to use it and that you understand how to use it correctly. Below is a brief summary of how to properly use Breztri.
Priming Breztri
You need to prime your Breztri inhaler before using it for the first time. This helps make sure you breathe in the right amount of medicine. Follow the following steps to properly prime Breztri.
- Remove the mouthpiece.
- Shake the inhaler.
- Spray one test puff into the air, pointing it away from your face.
- Repeat steps two and three for a total of four test puffs.
If it has been more than seven days since you used your Breztri inhaler or you dropped it, you should reprime with two test puffs, shaking it between each puff.
Daily use
For asthma, Breztri is usually used by inhaling two puffs every morning and two puffs every evening.
- Shake Breztri before each puff.
- Exhale completely.
- Place the mouthpiece into your mouth and inhale one puff of Breztri deeply and slowly.
- Hold your breath as long as you can, for up to 10 seconds.
- Repeat these steps for the second puff.
- Rinse your mouth with water and spit the water out to reduce your risk of getting a fungal infection in your mouth (do not swallow the water).
You should not use Breztri more than two puffs twice a day. If you miss a dose, use the missed dose as soon as you realize you missed it. Then use your next dose at the normal time. Do not use extra or double doses to make up for a missed dose.
This dosing information is based on the Breztri product labeling. You should use Breztri exactly as your health care provider recommends, and follow the instructions that come with the inhaler. If you are unsure how to prime or use Breztri, talk to your pharmacist or other health care provider.
Will I Still Need Any Other Inhalers?
Yes, you may sometimes need to use other inhalers if you have sudden breathing problems or an asthma attack. For some people with asthma, Breztri will be the only inhaler that needs to be used every day to prevent and control asthma symptoms. But you should always have access to a “rescue inhaler.” Rescue inhalers can give you quick relief from symptoms when you are having sudden trouble breathing or an asthma attack.
Breztri is a “maintenance” or “controller” inhaler. It should be used daily to prevent asthma symptoms. Breztri is not a rescue inhaler and should not be used to manage sudden breathing issues.
How Quickly Does Breztri Aerosphere Start Working?
Breztri starts working from the first dose, but it may take some time to notice a difference. In studies, changes in lung function were usually noticeable as early as four weeks after starting the medicine. Do not change or stop any medicines used to control or treat your asthma without instructions from your health care provider. They will monitor your progress and change your treatment plan as needed. Keep in mind that individual responses can vary, and it may take longer for some people to notice a difference than others.
Tell your health care provider if your symptoms don’t improve after one month of using Breztri. Your health care provider may ask you to show them how you use your inhaler to be sure you are using it properly. Otherwise, you and they can discuss other options for treating asthma.
Contact your health care provider right away if your breathing problems get worse or if you need to use your rescue inhaler more often than before starting Breztri. Also, contact them if your rescue inhaler seems less effective than before.
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