Sara Barile - Academia.edu (original) (raw)

Papers by Sara Barile

BMC Pulmonary Medicine, 2021

Background Inhaler selection is important when managing respiratory conditions; a patient’s inhal... more Background Inhaler selection is important when managing respiratory conditions; a patient’s inhalation technique should be appropriate for the selected device, and patients should ideally be able to use a device successfully regardless of disease severity. The NEXThaler is a multidose dry-powder inhaler with a breath-actuated mechanism (BAM) and dose counter that activates only following inhalation, so effectively an ‘inhalation counter’. We assessed inspiratory flow through the NEXThaler in two studies and examined whether inhalation triggered the BAM. Methods The two studies were open-label, single-arm, and single visit. One study recruited patients with asthma aged ≥ 18 years; the other recruited patients with chronic obstructive pulmonary disease (COPD) aged ≥ 40 years. All patients inhaled twice through a placebo NEXThaler. The inspiratory profile through the device was assessed for each inhalation using acoustic monitoring, with flow at and time to BAM firing, peak inspiratory...

ERS International Congress 2021, Jul 29, 2021

Additional file 1. Device usability questionnaire and results.

Additional file 1. Questionnaire.

Airway pharmacology and treatment, 2021

Introduction: The quality of life (QoL) and device needs have not been characterized in asthmatic... more Introduction: The quality of life (QoL) and device needs have not been characterized in asthmatic patients treated via dry powder inhalers (DPIs). The aim of this study was to assess the impact of asthma on health-related QoL, device satisfaction and preference in adult asthmatic patients using DPI devices, and to identify any DPI-associated unmet needs.Methods: An online survey was conducted between November and December 2019 on eligible patients from the Cint consumer panel across Europe. Newly designed, as well as validated questionnaires were used to collect data on QoL and inhaler satisfaction.Results: A total of 1063 asthmatic patient took part in the survey; 66% of the patients reported medium or high impact of asthma on the overall QoL. The majority of patients (61%) reported high level of satisfaction with their current device. The patients with medium-to-high impact of asthma on QoL were significantly less likely to be satisfied with their current device (55%) than those w...

Journal of Aerosol Medicine and Pulmonary Drug Delivery, 2021

Background: Peripheral deposition of inhaled medication is important as small airway disease has ... more Background: Peripheral deposition of inhaled medication is important as small airway disease has a key role in asthma. In this study, we compared the lung deposition at different mean flow rates of three inhaled corticosteroid (ICS)/long-acting beta 2-agonist (LABA) combinations delivered by dry powder inhaler (DPI), that is, Foster NEXThaler Ò (extrafine formulation of beclomethasone/formoterol), Relvar Ellipta Ò (fluticasone furoate/vilanterol trifenatate), and Symbicort Turbohaler Ò (budesonide/formoterol). Materials and Methods: In vitro drug delivery parameters were applied to lung computerized tomography (CT) scans of 20 asthma patients by functional respiratory imaging (FRI). Aerosol airway deposition patterns were calculated as percentage (standard deviation) intrathoracic versus extrathoracic deposition, percentage peripheral deposition, and central-to-peripheral (C/P) ratio at different inspiratory mean flow rates. Results: At 60 and 40 L/min, intrathoracic deposition of ICS/LABA was significantly higher with NEXThaler versus Ellipta. Peripheral deposition (60 L/min) with NEXThaler was higher than Ellipta for ICS (24.7% [3.5%] vs. 5.0% [2.0%]; p < 0.001) and LABA (25.3% [3.5%] vs. 13.0% [3.0%]; p < 0.001). C/P ratio with NEXThaler was lower (indicating higher peripheral deposition) than Ellipta (ICS: 0.63 vs. 1.63; LABA: 0.63 vs. 0.99). Inspiratory flow rate did not impact lung deposition with NEXThaler or Ellipta. In contrast, Turbohaler performance was negatively impacted by decreasing inspiratory flow rate. In fact, although lung deposition with Turbohaler was similar to that of NEXThaler at 60 L/min, lung deposition with Turbohaler was significantly lower than NEXThaler at both 40 L/min (*30%) and 30 L/min (*50%). Conclusions: Using FRI, we demonstrated better peripheral deposition and C/P ratios of ICS/LABA with NEXThaler versus Ellipta. NEXThaler demonstrated inspiratory flow rate independency of lung deposition versus Turbohaler. These findings suggest that the extrafine formulation is superior to large particle formulations in delivering ICS/LABA consistently both to the large and small airways.

Asthma Research and Practice, 2021

Background The treatment with short-acting beta-2 agonists (SABA) alone is no longer recommended ... more Background The treatment with short-acting beta-2 agonists (SABA) alone is no longer recommended due to safety issues. Instead, the current Global Initiative for Asthma (GINA) Report recommends the use of the combination of inhaled corticosteroids (ICS) with the rapid/long-acting beta-2 agonist formoterol, although the use in steps 1 and 2 is still off-label in the EU and in many countries. It is important to understand clinicians’ knowledge and opinions on the issue with the ultimate goal to encourage the implementation of the new approach in clinical practice. Methods We performed an international survey, directed to pulmonologists interested in the management of patients with asthma. Results Most participants reported that SABA alone should not be used in GINA Step 1 asthma treatment. As-needed low-dose ICS/formoterol combination to patients in step 1, and as-needed low-dose ICS/formoterol as reliever therapy in any step were found to be of current use prescribed in their real-li...

Phosphorus, Sulfur, and Silicon and the Related Elements, 2020

Abstract In medical and pharmaceutical science phosphonic acids and phosphonates play an importan... more Abstract In medical and pharmaceutical science phosphonic acids and phosphonates play an important role with regard to their wide application in various drugs as medicines against osteoporosis or antiviral agents. In the course of the investigations on the coordination chemistry of biologically active phosphonates different salts of the phosphonoformate anion were prepared via hydrolysis of corresponding esters under basic conditions. Depending on the reaction and crystallization conditions, different sodium salts with the phosphonoformate moiety were obtained and structurally characterized. GRAPHICAL ABSTRACT

Phosphorus, Sulfur, and Silicon and the Related Elements, 2018

Abstract Phosphonoformate – the simplest member of the group of phosphono-carboxylic-acids contai... more Abstract Phosphonoformate – the simplest member of the group of phosphono-carboxylic-acids containing a phosphonic as well as a directly bonded carboxylic moiety - can be regarded as a structural mimic of the pyrophosphate anion, a very important building block in biochemistry involved in processes of energy transfer as well as in growth of DNA or RNA strands. This derivative selectively inhibits the pyrophosphate binding side on viral polymerases, which qualifies the title compound as an antiviral medication used in the treatment of herpes viruses including drug-resistant cytomegaloviruses and as part of salvage therapy for highly treatment-experienced patients infected with HIV. Surprisingly only the crystal structure of the widely used trisodium salt is reported in the literature, whereas the coordination behavior towards other (earth) alkaline as well as transition metals is still unexplored. First insights into this field are reported in this work. Graphical Abstract