Table 1

Summary of trials comparing salbutamol delivered via CFC-free devices and via CFC-MDI

Ref. no.		Patient numbers and characteristics		Study design		Intervention^1-a		Dose of salbutamol via CFC-MDI	Dose of salbutamol via CFC-free device	Outcome measures	Interpretation of result
Ref. no.		Patient numbers and characteristics		Study design		Intervention^1-a		Dose of salbutamol via CFC-MDI	Dose of salbutamol via CFC-free device	Outcome measures	Efficacy^1-b	Potency
(a) Trials comparing salbutamol delivered via Airomir (HFC-MDI) and CFC-MDI
8	25 moderately asthmatic adults	DB crossover R, PC	Single dose on separate days	100 or 200 μg	100, 200 or 300 μg	FEV₁	HFC-MDI = CFC-MDI	HFC-MDI = CFC-MDI
9	44 mild to moderately asthmatic children	DB crossover R	Single dose	200 μg (Volumatic^® spacer device)	200 μg (Volumatic^® spacer device)	FEV₁, VC	HFC-MDI = CFC-MDI
10	24 moderately asthmatic adults	SB crossover R, PC	Cumulative dosing	100–1600 μg	100–1600 μg	FEV₁	HFC-MDI = CFC-MDI	HFC-MDI = CFC-MDI
11	24 mild to moderately asthmatic adults	SB crossover R	Cumulative dosing	100–1600 μg	100–1600 μg	FEV₁, FVC, FEF_25–75%	HFC-MDI = CFC-MDI	HFC-MDI = CFC-MDI
12	565 moderately asthmatic adults	DB parallel R, PC	12 weeks	200 μg qid	200 μg qid	FEV₁	HFC-MDI = CFC-MDI
13	63 asthmatic children	Open parallel R	4 weeks	200 μg qid	200 μg qid	FEV₁	HFC-MDI = CFC-MDI
(b) Trials comparing salbutamol delivered via Evohaler (HFC-MDI) and CFC-MDI
14	20 mild to moderately asthmatic adults	DB crossover R, PC	Single dose on separate days	100 μg, 200 μg	100 μg, 200 μg	FEV₁	HFC-MDI = CFC-MDI
15	24 asthmatic adults	DB crossover R, PC	Single dose	200 μg (spacer device)	200 μg (spacer device)	Histamine PD₂₀, FEV₁	HFC-MDI = CFC-MDI
16	25 asthmatic children	DB crossover R, PC	Single dose	200 μg (spacer device)	200 μg (spacer device)	Histamine PD₂₀, FEV₁	HFC-MDI = CFC-MDI
17	423 mild to moderately asthmatic adults	DB parallel R	4 weeks	400 μg per day	400 μg per day	Total daily dose, PEFR, FEV₁	HFC-MDI = CFC-MDI
(c) Trials comparing salbutamol delivered via Rotahaler (ROT) and CFC-MDI
18	20 adults	DB crossover R, PC	Single dose on separate days	200 μg	200, 400, 600 μg	FEV₁, FVC	ROT = CFC-MDI
19	10 acutely asthmatic adults	DB crossover R	Single dose on separate days	200 μg	50, 100, 200, 400 μg	PEFR	ROT = CFC-MDI
20	10 moderately asthmatic adults	DB crossover R, PC	Single dose on separate days	200 μg	200, 400 μg	FEV₁, VC	ROT = CFC-MDI
21	22 moderate to severely asthmatic adults	DB crossover PC	Single dose on separate days	200 μg	400 μg	PEFR	ROT = CFC-MDI
22	9 moderate to severely asthmatic adults	crossover R	Single dose on separate days	400 μg	400 μg	FEV₁, PEFR, FVC	ROT < CFC-MDI (FEV₁)	ROT < CFC-MDI
23	44 mildly asthmatic adults	DB crossover R, PC	Single dose on separate days	200 μg	200 μg	FEV₁	ROT = CFC-MDI
24	14 adults	crossover R	Cumulative dosing	100–1500 μg	100–1500 μg	FEV₁, FVC	ROT = CFC-MDI	ROT = CFC-MDI
25	7 adults	open crossover R	Cumulative dosing	100–4400 μg	200–9000 μg	FEV₁, FVC	ROT = CFC-MDI	ROT = CFC-MDI
26	25 children	DB crossover R, PC	Cumulative dosing	100–200 μg	100–400 μg	FEV₁, FVC, FEF_25–75%	ROT = CFC-MDI	ROT = CFC-MDI
27	27 severely asthmatic adults	Open parallel R	Cumulative dosing	3600 μg total (spacer device)	3600 μg total	FEV₁	ROT = CFC-MDI	ROT = CFC-MDI
24	12 adults	Open crossover R	1 month	674 μg/day	790 μg/day	Total daily dose, PEFR	ROT = CFC-MDI
26	185 mild to moderately asthmatic children	DB parallel R	3 months	200 μg qid	200 μg qid	FEV₁, FVC, FEF_25–75%	ROT = CFC-MDI
28	38 adults	DB sequential	3 months	720 μg/day	660 μg/day	Total daily dose, PEFR, FEV₁	ROT = CFC-MDI
29	43 moderately asthmatic children	DB crossover R	1 month	320 μg/day	660 μg/day	Total daily dose, PEFR	ROT > CFC-MDI (PEFR)
(d) Trials comparing salbutamol delivered via Diskhaler (DISK) and CFC-MDI
30	41 adults	DB crossover R, PC	Single dose on separate days	200 μg	400 μg	FEV₁	DISK = CFC-MDI
31	11 mildly asthmatic adults	DB crossover	Single dose on separate days	200 μg	400 μg	FEV₁, VC, FRC, FEV₁PC₂₀	DISK = CFC-MDI
32		9 moderately asthmatic adults		Open crossover R		Single dose on separate days		400 μg	400 μg	FEV₁, urinary salbutamol	DISK = CFC-MDI (FEV₁)	DISK = CFC-MDI
32		9 moderately asthmatic adults		Open crossover R		Single dose on separate days		400 μg	400 μg	FEV₁, urinary salbutamol	DISK > CFC-MDI (urinary excretion)	DISK = CFC-MDI
(e) Trials comparing salbutamol delivered via Accuhaler and CFC-MDI
33	24 mild to moderately asthmatic adults	DB crossover R, PC	Single dose on separate days	200 μg	200 μg	FEV₁, PEFR	Accuhaler = CFC-MDI
34	30 mild to moderately asthmatic	DB crossover	Single dose on separate days	200 μg	200 μg	FEV₁, PC₂₀	Accuhaler = CFC-MDI
(f) Trials comparing salbutamol delivered via Clickhaler (CLICK) and CFC-MDI
35	16 mild, moderate and severely asthmatic adults	DB crossover R, PC	Single dose on separate days	200 μg	200 μg	FEV₁	CLICK = CFC-MDI
36	85 mild to moderately asthmatic children	Crossover	Single dose on separate days	100 μg (spacer device)	100 μg	FEV₁, FVC, PEFR	CLICK = CFC-MDI
37	62 mild to moderately asthmatics	DB crossover R	Cumulative dosing	100–400 μg	100–400 μg	FEV₁, FVC, PEFR	CLICK = CFC-MDI	CLICK = CFC-MDI

↵1-a Time refers to duration of treatment per group.
↵1-b Comparative efficacy at the doses used in each study.
SB = single blind; DB = double blind; R = randomised; PC = placebo controlled; VC = vital capacity; FVC = forced vital capacity; FEF_25–75% = forced expiratory flow between 25% and 75% of FVC; Vmax₅₀ = 50% maximum instantaneous forced expiratory flow; FRC = functional residual capacity; VTG = volume of trapped gas; Rrs = respiratory system resistance; sGaw = specific airway resistance; (=) = equieffective (or potent); more (>) and less (<) effective (potent); tending to be more (=) or less (=) effective (potent).