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Background Growing concern around the global warming potential (GWP) of hydrofluoroalkane 134a (HFA-134a) propellant used in pressurized metered dose inhaler (pMDI) for asthma and COPD has prompted research into alternatives like HFA-152a, with a significantly lower GWP.A new formulation of CHF1535 [beclometasone dipropionate (BDP)/formoterol fumarate (FF)] 100/6 µg medium strength (MS) and 200/6 µg high strength (HS) has been developed with HFA-152a. Bioequivalence with CHF1535 HFA-134a marketed formulation should be demonstrated for BDP, B17MP (active metabolite of BDP) and Formoterol.Methods Two single-dose, double-blind, randomized, 4-way crossover studies with CHF1535 MS or HS were conducted in healthy volunteers, administered with a single dose of 4 inhalations of each formulation with HFA-152a or HFA-134a, with and without the use of the AeroChamber Plus ® spacer. Primary PK endpoints were Cmax, AUC0-t and tmax for all analytes and AUC0–30 min for Formoterol only, to assess lung availability and systemic effect. Safety was monitored.Results The 90% confidence intervals of all PK parameter ratios between HFA-152a and HFA-134a for lung availability and total systemic exposure were within the bioequivalence acceptance interval (80.00–125.00%) for both strengths, with and without the spacer. There was no shift in median t max. No safety signals were observed.Conclusions Therapeutic equivalence between the two formulations was demonstrated, supporting the timely introduction of therapeutic options enabling a seamless transition for patients, while minimizing climate impact.