HQ Team
May 12, 2025: British-Swedish AstraZeneca Plc’s medicine used for adults with chronic obstructive pulmonary disease has been approved in the UK with a new propellant suited for the environment.
A propellant is a special gas or liquid inside a metered-dose inhaler that helps push the medicine out of the inhaler as a fine mist or aerosol so you can breathe it into your lungs.
It acts like a force or energy source to spray the medicine in small droplets that can reach deep into the airways.
Trixeo Aerosphere is a mix of budesonide, glycopyrronium, and formoterol fumarate used to treat the disease. It’s also known as Breztri Aerosphere in the US, China, and Japan.
It helps people breathe easier by widening the airways and reducing inflammation.
Global warming
The new version uses a propellant called HFO-1234ze(E) that has a global warming potential (GWP) that is 99.9% lower than the propellants in current inhalers and won’t contribute as much to global warming.
The approval by the UK Medicines and Healthcare Products Regulatory Agency was based on results from the next-generation propellant clinical development programme, which demonstrated bioequivalence between Trixeo with the new propellant, and Trixeo with the current propellant, HFA-134a.
“The safety and tolerability profile for Trixeo with the next-generation propellant was consistent with the known profile of the medicine,” according to a company statement.
Normal metered-dose inhalers have a significant carbon footprint as they use propellants with climate-change gases. Trixeo Aerosphere has a low carbon footprint, similar to inhalers that don’t need a propellant.
Trixeo Aerosphere is a fixed-dose triple combination therapy, meaning it combines three medicines in one inhaler. Formoterol relaxes airway muscles, glycopyrronium also relaxes airway muscles, and budesonide reduces inflammation.
Safety profile
Studies showed that the new Trixeo Aerosphere works just as well as the old one, with a similar safety profile. It helps people with the pulmonary disease breathe better and reduces flare-ups of the disease, according to a company statement.
The new propellant is also being reviewed for approval in Europe, China, and other countries, the company stated.
.Ruud Dobber, Executive Vice President, BioPharmaceuticals Business Unit, AstraZeneca, said: “We are addressing the needs of both patients and the environment in devastating diseases like the chronic obstructive pulmonary disease, which affects hundreds of millions of people and is a leading cause of death globally.”
Trixeo is the first medicine in AstraZeneca’s portfolio of pressurised metered dose inhalers (pMDI) to transition to the new propellant. AstraZeneca aims to transition its wider pMDI portfolio to the near-zero GWP propellant by 2030 as part of the Company’s Ambition Zero Carbon strategy.
In the UK, the Company plans to initiate the transition of Trixeo to the next-generation propellant in the coming months.
COPD kills 3.5 million people
Chronic respiratory diseases, including COPD, affect hundreds of millions of people around the world.
Respiratory inhaled medicines delivered by pMDIs account for 78% of inhaler usage globally and contribute 0.04% of global greenhouse gases.
Chronic obstructive pulmonary disease is the fourth leading cause of death worldwide, causing 3.5 million deaths in 2021, approximately 5% of all global deaths, according to the WHO.
In the UK, pMDIs make up 70% of all inhaled medicines use, with inhaler emissions representing 3% of the total NHS carbon footprint.
Honeywell pact
AstraZeneca’s new propellant is developed and patented by Honeywell. The company announced in 2022 its collaboration with Honeywell to develop respiratory-inhaled medicines using the new propellant.
Karin Smyth, UK Minister of State for Health, said: “With 1.2 million people using inhalers in the UK, there is no doubt about the impact they have on the environment. Through our Plan for Change, we will lower our carbon footprint in our mission towards Net Zero and rebuild our NHS.”
Trixeo Aerosphere is used twice daily (two puffs in the morning and evening) as a long-term maintenance treatment. No changes have been made to the active ingredients, recommended dose or clinical use.
