Hanada Soichiro, Wada Shota, Ohno Takeshi, Sawaguchi Hirochiyo, Muraki Masato, Tohda Yuji
Department of Respiratory Medicine and Allergology, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan.
Department of Respiratory Medicine and Allergology, Kinki University Faculty of Medicine, Osakasayama, Japan.
Int J Chron Obstruct Pulmon Dis. 2015 Jan 6;10:69-77. doi: 10.2147/COPD.S73521. eCollection 2015.
Tiotropium (Spiriva) is an inhaled muscarinic antagonist for patients with chronic obstructive pulmonary disease (COPD), and is available in two forms: the HandiHaler and the Respimat inhaler. The aim of this study was to investigate the handling of and preference for each device immediately after switching from the HandiHaler to the Respimat and 2-3 years after the switch.
The study comprised two surveys. A questionnaire was first administered to 57 patients with COPD (male:female 52:5, mean age 73.6±7.1 years) 8 weeks after switching from the HandiHaler (18 μg) to the Respimat (5 μg). A second similar but simplified questionnaire was administered to 39 of these patients who continued to use the Respimat and were available for follow-up after more than 2 years. Pulmonary function was also measured during each period.
In the first survey, 17.5% of patients preferred the HandiHaler, and 45.6% preferred the Respimat. There were no significant changes in pulmonary function or in the incidence of adverse events after the switch. In the second survey, performed 2-3 years later, the self-assessed handling of the Respimat had significantly improved, and the number of patients who preferred the Respimat had increased to 79.5%.
The efficacy of the Respimat was similar to that of the HandiHaler. This was clear immediately after the switch, even in elderly patients with COPD who were long-term users of the HandiHaler. The preference for the Respimat increased with continued use.
噻托溴铵（思力华）是一种用于慢性阻塞性肺疾病（COPD）患者的吸入性毒蕈碱拮抗剂，有两种剂型：HandiHaler和Respimat吸入器。本研究的目的是调查从HandiHaler转换至Respimat后即刻以及转换2至3年后患者对每种装置的操作情况及偏好。
本研究包括两项调查。首先，在57例COPD患者（男∶女为52∶5，平均年龄73.6±7.1岁）从HandiHaler（18μg）转换至Respimat（5μg）8周后进行问卷调查。第二项类似但简化的问卷针对其中39例继续使用Respimat且在2年多后可进行随访的患者。在每个阶段还测量了肺功能。
在首次调查中，17.5%的患者更喜欢HandiHaler，45.6%的患者更喜欢Respimat。转换后肺功能或不良事件发生率无显著变化。在2至3年后进行的第二次调查中，患者对Respimat的自我评估操作情况有显著改善，更喜欢Respimat的患者比例增至79.5%。
Respimat的疗效与HandiHaler相似。即使在长期使用HandiHaler的老年COPD患者中，转换后即刻也是如此。随着持续使用，对Respimat的偏好增加。
