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新型福莫特罗多剂量干粉吸入器对哮喘治疗的改善作用。

Improvement of asthma therapy by a novel formoterol multidose dry powder inhaler.

作者信息

Moeller Manfred, Grimmbacher Stefanie, Munzel Ullrich

机构信息

Practice for Pneumology, Internal Medicine, Allergology, Hanau, Germany.

出版信息

Arzneimittelforschung. 2008;58(4):168-73. doi: 10.1055/s-0031-1296488.

Abstract

The objective of this post-marketing surveillance (PMS) was the evaluation of efficacy, tolerability, and acceptance of the advanced formoterol (CAS 73573-87-2) multidose dry powder inhaler (MDPI) Formatris 6 microg/12 microg Novolizer (FN) in asthmatic patients (n = 5219) in a real-life setting. A total of 2727 patients (52%) received concomitant anti-inflammatory treatment exclusively via a budesonide Novolizer (BN). Efficacy of the FN was assessed by measurement of peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) before and after 4 weeks of therapy. The severity of cough, wheezing, diurnal dyspnea, nocturnal dyspnea and dyspnea on physical effort were assessed on a four-point scale, and a severity sum score was calculated. The patients' satisfaction with the multiple feedback mechanisms, handling and safety of the FN was also assessed. The physicians judged the patient compliance and any improved inhalation reassurance due to FN control mechanisms in comparison with other inhalation systems. FN use (n = 2727) was associated with improved lung function. After 4 weeks, PEF increased by 26% (from 270 L/min to 340 L/min) and the median FEV1 increased by 24% (from 2.1 L to 2.6 L). The median severity sum score decreased from 8.0 before therapy to 3.0 after therapy. Most patients assessed the control mechanisms and safety functions of the FN as 'very good' or 'good'. 96% of patients were satisfied with the optical control mechanism, 92% with the acoustic mechanism, 70% with the taste feedback, 89% with the dose counter and 76% with the overdose prevention. The majority of patients (95%) confirmed that the multiple feedback mechanisms reassured correct drug intake, with 83% rating the FN as 'much better' or 'better' than previously used inhalers. The physicians confirmed that in contrast to previously used inhalers the FN ensured correct inhalation in 87% of all patients. The physicians were satisfied with the patients' compliance in 95% of cases. Finally, the majority of patients (98%) were highly satisfied with the correct inhalation feedback mechanism. 94% of patients intended to continue FN therapy beyond the study. Overall, FN reduced the patients' asthma symptoms and improved lung function, possibly due to improved compliance with therapy. The correct inhalation feedback mechanisms and safety functions of the device were assessed very positively by patients and were considered by the physicians to be important in improving inhalation reassurance and patient compliance.

摘要

本次上市后监测(PMS)的目的是在实际环境中评估先进的福莫特罗(CAS 73573-87-2)多剂量干粉吸入器(MDPI)Formatris 6微克/12微克诺沃吸入器(FN)在哮喘患者(n = 5219)中的疗效、耐受性和可接受性。共有2727名患者(52%)仅通过布地奈德诺沃吸入器(BN)接受联合抗炎治疗。通过在治疗4周前后测量呼气峰值流速(PEF)和一秒用力呼气容积(FEV1)来评估FN的疗效。咳嗽、喘息、日间呼吸困难、夜间呼吸困难和体力活动时呼吸困难的严重程度采用四点量表进行评估,并计算严重程度总分。还评估了患者对FN的多种反馈机制、操作和安全性的满意度。医生判断患者的依从性以及与其他吸入系统相比,FN控制机制是否能提高吸入的可靠性。使用FN(n = 2727)与肺功能改善相关。4周后,PEF增加了26%(从270升/分钟增至340升/分钟),FEV1中位数增加了24%(从2.1升增至2.6升)。严重程度总分中位数从治疗前的8.0降至治疗后的3.0。大多数患者对FN的控制机制和安全功能评价为“非常好”或“好”。96%的患者对光学控制机制满意,92%对声学机制满意,70%对味觉反馈满意,89%对剂量计数器满意,76%对过量预防满意。大多数患者(95%)确认多种反馈机制确保了正确的药物吸入,83%的患者将FN评为比以前使用的吸入器“好得多”或“更好”。医生确认,与以前使用的吸入器相比,FN在所有患者中有87%确保了正确吸入。医生对95%的患者依从性感到满意。最后,大多数患者(98%)对正确的吸入反馈机制高度满意。94%的患者打算在研究结束后继续使用FN治疗。总体而言,FN减轻了患者的哮喘症状并改善了肺功能,这可能是由于治疗依从性提高所致。该装置正确的吸入反馈机制和安全功能得到了患者的高度评价,医生认为这些机制对提高吸入可靠性和患者依从性很重要。

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