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慢性阻塞性肺疾病(COPD)患者对两种干粉吸入器的正确使用、易用性及偏好:五项III期随机试验分析

Correct usage, ease of use, and preference of two dry powder inhalers in patients with COPD: analysis of five phase III, randomized trials.

作者信息

Riley John H, Tabberer Maggie, Richard Nathalie, Donald Alison, Church Alison, Harris Stephanie S

机构信息

MDC Global Clinical Development - UK, GlaxoSmithKline.

Value Evidence and Outcomes, GlaxoSmithKline, Uxbridge, Middlesex, UK.

出版信息

Int J Chron Obstruct Pulmon Dis. 2016 Aug 16;11:1873-80. doi: 10.2147/COPD.S109121. eCollection 2016.

Abstract

BACKGROUND

Handheld inhalers are used to deliver treatment for COPD. Incorrect usage leads to suboptimal disease control. Complex treatment regimens and use of multiple inhalers may reduce patient compliance. The Anoro Ellipta™ dry powder inhaler (DPI) simultaneously delivers umeclidinium bromide (UMEC) and vilanterol (VI) without coformulation being required.

AIM

To assess the correct usage and ease of use of the Ellipta™ DPI administering UMEC/VI and to compare patient preference for Ellipta™ with the HandiHaler(®) through exploratory analyses of patient and observer questionnaires in five Phase III studies.

METHODS

Two Phase III, 3-month double-blind, placebo-controlled studies assessed the correct usage of the Ellipta™ DPI at Day 1 and after 6 weeks, and ease of use of the Ellipta™ DPI using a nonvalidated patient questionnaire after 6 weeks or early withdrawal. In three 6-month, blinded double-dummy, active comparator studies (two Phase IIIa and one Phase IIIb), patients completed a COPD device preference questionnaire between the Ellipta™ DPI and the Handi-Haler(®) at Day 168 (Week 24) or early withdrawal.

RESULTS

In the 3-month placebo-controlled studies, ≥98% of patients used the Ellipta™ DPI correctly and 99% of patients found the inhaler easy/very easy-to-use and the dose counter easy/very easy to read. Across the two Phase IIIa active comparator studies, patients consistently stated a preference for the Ellipta™ DPI over HandiHaler(®) regarding the number of steps to use (59% vs 17%), time taken to use (62% vs 14%), and ease of use (63% vs 15%) regardless of which inhaler contained active drug. Results were consistent in the Phase IIIb active comparator study.

CONCLUSION

Delivery of UMEC/VI via the Ellipta™ DPI was considered easy-to-use, and patients with COPD demonstrated clear preference for this inhaler compared with HandiHaler(®).

摘要

背景

手持吸入器用于递送慢性阻塞性肺疾病(COPD)的治疗药物。使用不当会导致疾病控制不佳。复杂的治疗方案以及使用多种吸入器可能会降低患者的依从性。安立生坦/维兰特罗干粉吸入器(Anoro Ellipta™ DPI)可同时递送溴化乌美溴铵(UMEC)和维兰特罗(VI),无需共混制剂。

目的

通过对五项III期研究中患者和观察者问卷的探索性分析,评估Ellipta™ DPI 吸入器递送UMEC/VI的正确使用方法和易用性,并比较患者对Ellipta™ DPI与都保(HandiHaler(®))的偏好。

方法

两项为期3个月的III期双盲、安慰剂对照研究评估了Ellipta™ DPI在第1天和6周后的正确使用方法,并在6周或提前退出研究后,使用一份未经验证的患者问卷评估了Ellipta™ DPI的易用性。在三项为期6个月的双盲双模拟、活性对照研究(两项IIIa期和一项IIIb期)中,患者在第168天(第24周)或提前退出研究时,完成了一份关于Ellipta™ DPI与都保(Handi-Haler(®))的COPD设备偏好问卷。

结果

在为期3个月的安慰剂对照研究中,≥98%的患者正确使用了Ellipta™ DPI,99%的患者认为该吸入器易于/非常易于使用,剂量计数器易于/非常易于读取。在两项IIIa期活性对照研究中,无论哪种吸入器含有活性药物,患者始终表示,在使用步骤数量(59%对17%)、使用所需时间(62%对14%)和易用性(63%对15%)方面,他们更喜欢Ellipta™ DPI而非都保(HandiHaler(®))。IIIb期活性对照研究的结果一致。

结论

通过Ellipta™ DPI递送UMEC/VI被认为易于使用,与都保(HandiHaler(®))相比,COPD患者对这种吸入器表现出明显的偏好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a718/4996255/2875525c0894/copd-11-1873Fig1.jpg

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The ELLIPTA® Dry Powder Inhaler: Design, Functionality, In Vitro Dosing Performance and Critical Task Compliance by Patients and Caregivers.
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