Inhalation therapy devices for the treatment of obstructive lung diseases: the history of inhalers towards the ideal inhaler

Sorino, Claudio; Negri, Stefano; Spanevello, Antonio; Visca, Dina; Scichilone, Nicola

doi:10.1016/j.ejim.2020.02.023

Cited by 83 publications

(60 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in DPIs, micronised drug particles are attached to larger lactose carrier particles. No coordination between actuation and inhalation is required but the patient is supposed to produce an adequate inspiratory flow to extract the drug from inhaler and disaggregate it from the carrier 10‐12 . Therapeutic success depends on the maintenance of a correct inhalation technique 11,13 .…”

Section: Introductionmentioning

confidence: 99%

Real‐life assessment of chronic obstructive pulmonary disease patient performance with different inhalers

et al. 2020

View full text Add to dashboard Cite

Purpose This study aimed to evaluate handling of six common inhalers and to determine correlations between correct inhaler technique and patient demographics/ clinical variables. Methods A total of 180 chronic obstructive pulmonary disease (COPD) patients were crossed‐over to handle their past‐experienced inhalers among (pMDI, Aerolizer, Handihaler, Breezhaler, Turbohaler, and Diskus) randomly, without receiving verbal or demonstrative instruction (baseline assessment). Inhaler technique was assessed using previously defined checklists. The correct use of the inhaler was then demonstrated and the patient was evaluated for inhaler use again. Demonstration was repeated until a correct technique was achieved. Number of counselling attempts needed to a complete right handling, patient demographics and clinical variables were recorded. Results The mean percentage of total correct steps showed that pMDI is significantly lower than all other inhalers (76.01 ± 12.61 vs 84.18 ± 10.87, 84.60 ± 12.10, 85.91 ± 9.82, 90.63 ± 9.29 and 91 ± 10.22 for Diskus, Turbohaler, Aerolizer, Handihaler and Breezhaler, respectively, at P < .001). Breezhaler showed the lowest percentage of participants with at least 1 critical error (20%) however, pMDI showed the highest percentage (85.19%) at P < .05. Breezhaler showed that the highest percentage of participants achieved a complete right handling after 1st counselling attempt, however, pMDI was the only inhaler included in a 3rd and 4th counselling attempts (5.93% and 0.74%, respectively). Weak and very weak correlations were found between total correct steps and demographics/clinical variables. Conclusions pMDI is not preferable for handling by COPD patients. DPIs vary in ease of use, so that inhaler therapy must be individualised on basis of patient handling assessment with repeated counselling.

show abstract

Section: Introductionmentioning

confidence: 99%

Real‐life assessment of chronic obstructive pulmonary disease patient performance with different inhalers

et al. 2020

View full text Add to dashboard Cite

show abstract

“…To obtain pharmacotherapy success, patient adherence is important; this can depend on a patient's experience with their inhaler [5,6,8], as well as their coordination and inhalation capacity [4,9]. The Respimat Ò Soft Mist TM inhaler (SMI) is a suitable device for a wide range of patients [10][11][12], even for patients with low inspiratory flow [4], as dose delivery is independent of inspiratory capacity [11,13].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Patient Experiences with Respimat® in Everyday Clinical Practice

et al. 2020

View full text Add to dashboard Cite

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive disease requiring maintenance therapy. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy report, bronchodilation with long-acting muscarinic antagonists (LAMAs) and long-acting b 2-agonists (LABAs), administered via inhalers, is currently the mainstay of COPD treatment. Combined LAMA/LABA therapies have been shown to improve patient health status, lung function and breathlessness. Here, we wanted to report patient satisfaction with the Respimat Ò Soft Mist TM inhaler (SMI). Methods: This was a pooled analysis of SPIRIT Ò (NCT02675517) and OTIVACTO Ò (NCT02719639), two open-label, single-arm, non-interventional studies of physical function in patients with COPD. Patients were treated with tiotropium/olodaterol 5/5 lg for approximately 6 weeks via the SMI. SPIRIT was conducted in Germany; OTIVACTO was conducted in nine European countries. The primary endpoints have been reported previously. Here, we assess patient satisfaction with inhalation and handling, and patient adherence to treatment with the tiotropium/olodaterol SMI in patients with COPD. These were assessed through selfreported questionnaires and physician general assessments. Results: Baseline data were collected from 9180 patients from the SPIRIT and OTIVACTO studies. The majority of patients were GOLD group A (25.59%) or B (46.12%). After 6 weeks of treatment with tiotropium/olodaterol, 85.78% of patients were 'satisfied' or 'very satisfied' with inhaling from the device, and 84.33% of patients were 'satisfied' or 'very satisfied' with the handling of the inhaler. Treating physicians reported patient adherence as 'high' during the study, with 98.57% of patients regularly using the tiotropium/olodaterol SMI. Furthermore, 95.45% of patients expressed a willingness to continue using the tiotropium/olodaterol SMI at the end of the observation period. Conclusion: In this study, over 9000 patients reported satisfaction with respect to inhalation Digital Features To view digital features for this article go to

show abstract

“…Various devices can be used to administer OIDs to patients, including dry-powder inhalers (DPIs), pressurized metered-dose inhalers (pMDIs) and nebulizers. These devices have been extensively discussed in several recent works [18][19][20][21][22][23][24][25]. Briefly, DPIs deliver powder particles carrying the drug; pMDIs and nebulizers generate liquid droplets containing the drug.…”

Section: Inhalation Therapymentioning

confidence: 99%

Preclinical Development of Orally Inhaled Drugs (OIDs)—Are Animal Models Predictive or Shall We Move Towards In Vitro Non-Animal Models?

Movia

Prina-Mello

2020

Animals

View full text Add to dashboard Cite

Respiratory diseases constitute a huge burden in our society, and the global respiratory drug market currently grows at an annual rate between 4% and 6%. Inhalation is the preferred administration method for treating respiratory diseases, as it: (i) delivers the drug directly at the site of action, resulting in a rapid onset; (ii) is painless, thus improving patients’ compliance; and (iii) avoids first-pass metabolism reducing systemic side effects. Inhalation occurs through the mouth, with the drug generally exerting its therapeutic action in the lungs. In the most recent years, orally inhaled drugs (OIDs) have found application also in the treatment of systemic diseases. OIDs development, however, currently suffers of an overall attrition rate of around 70%, meaning that seven out of 10 new drug candidates fail to reach the clinic. Our commentary focuses on the reasons behind the poor OIDs translation into clinical products for the treatment of respiratory and systemic diseases, with particular emphasis on the parameters affecting the predictive value of animal preclinical tests. We then review the current advances in overcoming the limitation of animal animal-based studies through the development and adoption of in vitro, cell-based new approach methodologies (NAMs).

show abstract

Inhalation therapy devices for the treatment of obstructive lung diseases: the history of inhalers towards the ideal inhaler

Cited by 83 publications

References 39 publications

Real‐life assessment of chronic obstructive pulmonary disease patient performance with different inhalers

Real‐life assessment of chronic obstructive pulmonary disease patient performance with different inhalers

Assessment of Patient Experiences with Respimat® in Everyday Clinical Practice

Preclinical Development of Orally Inhaled Drugs (OIDs)—Are Animal Models Predictive or Shall We Move Towards In Vitro Non-Animal Models?

Contact Info

Product

Resources

About