Asthma and Airway Centre, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.
Int J Chron Obstruct Pulmon Dis. 2011;6:353-63. doi: 10.2147/COPD.S18529. Epub 2011 Jun 23.
For optimal efficacy, an inhaler should deliver doses consistently and be easy for patients to use with minimal instruction. The delivery characteristics, patients' correct use, and preference of two single-dose dry powder inhalers (Breezhaler and HandiHaler) were evaluated in two complementary studies. The first study examined aerodynamic particle size distribution, using inhalation profiles of seven patients with moderate to very severe chronic obstructive pulmonary disease (COPD). The second was an open-label, two-period, 7-day crossover study, evaluating use of the inhalers with placebo capsules by 82 patients with mild to severe COPD. Patients' correct use of the inhalers was assessed after reading written instructions on Day 1, and after training and 7 days of daily use. Patients' preference was assessed after completion of both study periods. Patient inhalation profiles showed average peak inspiratory flows of 72 L/minute through Breezhaler and 36 L/minute through HandiHaler. For Breezhaler and HandiHaler, fine particle fractions were 27% and 10%, respectively. In the second study, correct use of Breezhaler and HandiHaler was achieved by > 77% of patients for any step after 7 days; 61% of patients showed an overall preference for Breezhaler and 31% for HandiHaler (P = 0.01).Breezhaler is a low-resistance inhaler suitable for use by patients with a range of disease severities. Most patients used both inhalers correctly after 7 days, but more patients showed an overall preference for the Breezhaler compared with the HandiHaler. These are important factors for optimum dose delivery and successful COPD management.
为了达到最佳疗效，吸入器应持续稳定地输送剂量，且患者在使用时应易于操作，只需接受最少的指导。在两项互补研究中，评估了两种单剂量干粉吸入器（Breezhaler 和 HandiHaler）的输送特性、患者正确使用方法和偏好。第一项研究通过对 7 名中重度慢性阻塞性肺疾病（COPD）患者的吸入情况进行分析，评估了空气动力学颗粒大小分布。第二项研究是一项开放标签、双周期、7 天交叉研究，评估了 82 名轻至重度 COPD 患者使用安慰剂胶囊时对这两种吸入器的使用情况。患者在第一天阅读书面说明后、在接受培训和 7 天日常使用后评估吸入器的正确使用情况。在完成两个研究阶段后评估患者的偏好。患者的吸入特征显示，通过 Breezhaler 的平均吸气峰流速为 72L/分钟，通过 HandiHaler 的为 36L/分钟。对于 Breezhaler 和 HandiHaler，细颗粒分数分别为 27%和 10%。在第二项研究中，经过 7 天的任何步骤，>77%的患者都能正确使用 Breezhaler 和 HandiHaler；61%的患者总体上更喜欢 Breezhaler，31%的患者更喜欢 HandiHaler（P=0.01）。Breezhaler 是一种低阻力吸入器，适用于各种严重程度的患者。大多数患者在 7 天后都能正确使用两种吸入器，但更多患者总体上更喜欢 Breezhaler 而不是 HandiHaler。这些都是实现最佳剂量输送和成功 COPD 管理的重要因素。
