Trial reportThorax2022
Effects of switching from a metered dose inhaler to a dry powder inhaler on climate emissions and asthma control: post-hoc analysis.
Trial report in Thorax, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01706198 (A 12-month, Open Label, Randomised, Effectiveness Study to Evaluate Fluticasone Furoate), which is not on this map. Cited by 54 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A 12-month, Open Label, Randomised, Effectiveness Study to Evaluate Fluticasone Furoate (FF, GW685698)/Vilanterol (VI, GW642444) Inhalation Powder Delivered Once Daily Via a Novel Dry Powder Inhaler Compared With Usual Maintenance Therapy in Subjects With Asthma
Who cites it
54 citing papers in PubMed, 3 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Pooled it
- Implementation of decarbonisation actions in general practice: a systematic review and narrative synthesis.BMJ open · 2025Pooled it
- Clinician and health service interventions to reduce the greenhouse gas emissions generated by healthcare: a systematic review.BMJ evidence-based medicine · 2024Pooled it
- Comparing paper Letters in addition to Emailed Audit and feedback in Refining Asthma treatment to Improve clinical and environmental Results in primary care through a cluster randomised controlled trial: the CLEAR AIR study.BMJ open respiratory research · 2026Trial
- Sustainable asthma inhalers: who is offered the option to change, who declines and who successfully switches?BMJ open respiratory research · 2026Article
- Comprehensive Evaluation of Storage Stability and Cytotoxicity of Co-Spray-Dried Theophylline Dry Powders for Inhalation: Follow-Up Study.Pharmaceutics · 2026Article
- Environmental prescribing for asthma and chronic obstructive pulmonary disease.African journal of primary health care & family medicine · 2026Article
- Decarbonising Respiratory Care: The Impact of a Low-Carbon Salbutamol Pressurised Metered-Dose Inhalers.Allergy · 2026Article
- Educational Intervention on Environmentally Responsible Inhaler Prescribing Among French General Practitioners: Pilot Pre-Post Study.JMIR formative research · 2026Article
- Climate Change and the Switch from Pressurised Metered-Dose Inhalers to Dry Powder Inhalers: A Proportionate Balancing of Risk and Reward?Pulmonary therapy · 2026Review
- Green CKD care: 10 tips to make nephrology outpatient clinics more environmentally sustainable.Clinical kidney journal · 2026Review
- Supporting general practices to develop green action plans to reduce carbon emissions: development and evaluation of the feasibility of a workshop-based intervention.Primary health care research & development · 2026Article
- Estimation of carbon emissions from inhaled respiratory medicines in Ireland: a cross-sectional study from a national pharmacy claims database from 2020 to 2022.International journal of clinical pharmacy · 2026Article
- Ethical dilemmas in climate change and healthcare delivery: a cross-sectional survey of US patient perspectives.BMC medicine · 2026Article
- Air pollution, inhaled therapy and COPD exacerbations in Yunlin, Taiwan: a 2016-2024 single-centre retrospective cohort with environmental and carbon-footprint analyses.BMJ open respiratory research · 2025Observational
- Switching to the Dry Powder Inhaler: Disease Control with a Lower Carbon Footprint.Pulmonary therapy · 2025Article
- Assessing greenhouse gas emissions in a primary care subdistrict in Cederberg, South Africa.BMC health services research · 2025Article
- Inhaler use and their carbon footprint in Germany: a 10-year analysis (2013-2022).BMJ open respiratory research · 2025Article
- Modelling the climate impact of inhalers and mitigation strategies: a population-based study in British Columbia, Canada (2015-2032).BMJ open respiratory research · 2025Article
- Environmental sustainability in healthcare: impacts of climate change, challenges and opportunities.Singapore medical journal · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the effects of switching from a pressurised metered dose inhaler (pMDI)-based to a dry powder inhaler (DPI)-based maintenance therapy versus continued usual care on greenhouse gas emissions (carbon dioxide equivalents, CO
methodsThis post-hoc analysis was based on a subset of 2236 (53%) patients from the Salford Lung Study in Asthma who at baseline were using a pMDI-based controller therapy. During the study patients were randomised to fluticasone furoate/vilanterol (FF/VI) via the ELLIPTA DPI (switched from pMDI to DPI) (n=1081) or continued their usual care treatment (n=1155), and were managed in conditions close to everyday clinical practice. Annual CO
resultsThe groups were well matched for demographic characteristics and baseline Asthma Control Test (ACT) total score (mean age: 49 years; mean ACT score: usual care, 16.6; FF/VI, 16.5). Annual CO
conclusionsPatients switching from a pMDI-based to a DPI-based maintenance therapy more than halved their inhaler carbon footprint without loss of asthma control. The remaining inhaler carbon footprint could be reduced through switches from pMDI to DPI rescue medications or alternative lower-carbon footprint rescue inhalers if available. Asthma control improved in both groups, with greater control demonstrated in those initiated on FF/VI DPI. TRIAL REGISTRATION NUMBER: NCT01706198.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.