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The present paper deals with the preparation of ZnIn2S4−IIIa layer-type CdIn2S4-xSex (1.75≤ x ≤ 2.75) quaternary chalcogenides and their characterization. X-ray diffraction studies of CdIn2S4-xSex (1.75 ≤ x ≤ 2.75) confirmed that all of these compounds possess the ZnIn2S4−IIIa type of structure. The variation of the composition x shows that both lattice parameters a- and c increase with a growing amount of selenium in the crystals. The calculation of microstructural parameters by an X-ray line profile analysis has shown that the intercalation of lithium in the host CdIn2S2Se2 is accompanied by a decrease in crystallite size while the dislocation density and the rms strain are increasing. The process of intercalation results in no expansion along the c-axis, probably due to no increase in the c-parameter at all in a given intercalation process; which does not have purely geometric origin but also comes from electronic effects. A radial distribution function (RDF) analysis of these quaternary chalcogenides indicated the presence of peaks at ~2.5 and 4.5 Å metal−chalcogen and metal−metal distances, respectively. The peaks above 6 Å are due to the higher order metal−chalcogen and chalcogen−chalcogen distances. The apparent crystallite size of CdIn2S4-xSex (1.75 ≤ x ≤ 2.75) compounds deduced from X-ray studies has been correlated with the scanning electron micrographs. Scanning tunneling microscopic studies revealed that the surface of the CdIn2S2Se2 crystals is not smooth. All of the compounds are thermally stable up to about 450 °C in air atmosphere.

Several fixed-dose combination inhaled corticosteroid (FDC ICS/LABA) inhalers are licensed for chronic obstructive pulmonary disease (COPD) in the UK. This study compares effectiveness of Fostair 100/6 (BDP/FOR) metered dose inhalers (MDI) against other licensed FDC ICS/LABAs, namely; Seretide Accuhaler 500 (FP/SAL) dry powder inhaler (DPI) and Symbicort Turbohaler 200/6 and 400/24 DPI (BUD/FOR) in a patient group with recent exacerbations and poor lung function. A historical cohort study using data extracted from the Optimum Patient Care Research Database. Patients with diagnostic read codes for COPD, smoking history, age ≥35 years, postdose FEV1percent predicted <55%,≥1 previous long acting bronchodilator ever, and ≥1 previous exacerbation in the 18 months prior initiation of FDC ICS/LABA therapy. The observation period consisted of one year after the initiation of FDC ICS/LABA for follow up and one year prior for patient characterisation. Patients were excluded if they switched or halted ICS/LABA treatment during the 1 year follow up period. The primary outcome was the proportion of patients with ≥1 exacerbation. The non-inferiority margin was defined as 20%. Patients were directly matched 1:1 on categorised age, smoking status, FEV1percent predicted and exacerbations. Mean total costs consisting of medication/resource costs were compared between treatment arms after adjusting for confounders. Out of the patients prescribed BDP/FOR (n=537) and 537 FP/SAL (n=537), the median age was 70 and 69 respectively and 41.7% were current smokers. In the BDP/FOR (n=540) and BUD/FOR (n=540) comparison, the median age was 70 and 69 respectively, and 42% were current smokers. The risk of ≥1 exacerbation in BDP/FOR group was non-inferior during the year following the initiation of ICS/LABA compared to FP/SAL (OR 0.89, 95% CI: 0.67–1.19) or BUD/FOR (OR 0.79, 95% CI: 0.58–1.08). Cost was significantly lower for BDP/FOR versus FP/SAL (adjusted mean £730.0 versus £850.1 respectively, p<0.001) and lower for BDP/FOR versus BUD/FOR (adjusted mean £732.4 versus £757.2 respectively, p=0.054). Treatment with BDP/FOR is non-inferior in terms of exacerbation risk and is additionally associated with a lower point estimate of exacerbation risk, a lower cost compared to FP/SAL and BUD/FOR, and a lower ICS dose compared to FP/SAL.

BackgroundSpacers may be compatible but unlicensed for an inhaler device. A prior study showed that co-prescription of unlicensed spacers with non-extrafine (non-EF) beclometasone dipropionate (BDP) asthma therapy was common.1This study aimed to compare the occurrence of patient-reported inhaled corticosteroid (ICS)-related adverse events (AEs) in patients with asthma co-prescribed the licensed Volumatic or unlicensed Aerochamber spacer with their non-EF BDP therapy.MethodA cross-sectional study using completed questionnaires and data extracted from the Optimum Patient Care Research Database including patients with asthma, aged ≤65 years,≥2 prescriptions for non-EF BDP and co-prescription of either a Volumatic or Aerochamber spacer. Patient characterisation was performed for the year prior to receipt of the completed questionnaire. AEs captured via questionnaire included continual sore mouth/throat, oral thrush, hoarse voice, bruising, weight gain and cough. The primary outcome was non-inferiority of the proportion of patient-reported oral candidiasis (reported as oral thrush/hoarse voice). The two spacer groups were compared using logistic regression, adjusted for gender, ICS average dose and smoking status. Non-inferiority was claimed if the upper 95% confidence interval (CI) of the marginal effect estimate was <0.13. Comparisons by age (<16, 16–65,≥65 years) and ICS dose (<1000 µg,≥1000 µg) were additionally performed.ResultsOf the patients co-prescribed the licensed Volumatic spacer (n=155), 29.9% reported oral candidiasis, compared to 27.7% of patients co-prescribed the unlicensed Aerochamber device (n=385, p=0.622). The marginal effect estimate was −0.043 (95%CI −0.133, 0.047) and the Aerochamber was determined to be non-inferior to the Volumatic spacer. In terms of the total number of reported AEs, there were no significant differences for the main population (≤65 years) (p=0.797), 16–65 years (p=0.875),<16 years (p=0.687),≥65 years (p=0.425), high dose (p=0.084) and low dose (p=0.443) groups between those co-prescribed a Volumatic or an Aerochamber spacer.ConclusionCo-prescription of the unlicensed Aerochamber spacer with non-EF BDP asthma therapy, in recommended patient groups, does not increase the risk of developing oral candidiasis or other ICS-related AEs, as compared to co-prescription of the licensed, Volumatic device.ReferenceICARUS study submitted to PCRS2017.

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