Inhalationsdevices in der modernen Kombinationstherapie chronischer Atemwegserkrankungen

Zusammenfassung

Seit Kurzem sind fixe Kombinationen aus langwirksamen Anticholinergica und langwirksamen β2-Agonisten (LABA) verfügbar, ebenso wie zusätzliche Inhalationssysteme für die fixe Kombination aus LABA und inhalativen Kortikosteroiden. Die klinische Wirksamkeit der einzelnen Kombinationen unterscheidet sich dabei nicht wesentlich. Daher ist das beste System ist dasjenige Device, das der Patient langfristig korrekt benutzen kann, weil es seiner Präferenz entspricht und sachgerecht und wiederholt geschult wurde.

Abstract

New fixed combinations of long acting β₂-agonists and anti-muscarinic agents have been launched in the therapy of chronic obstructive airway disease. The clinical benefit of the different drug combinations appears to be comparable. Differences however exist in the performance of the respective device. Proper training and repeated patient education is paramount for efficient therapy and appears to be more important than the choice of the drug itself.

Schlüsselwörter

Fixkombination LABA / LAMA - Inhalationssystem - COPD

Keywords

Combination therapy LABA / LAMA - inhalation device - COPD

• Literatur

• 1 Magnussen H, Disse B, Rodriguez-Roisin R et al. Withdrawal of inhaled glucocorticoids and exacerbations of COPD. N Engl J Med 2014; 371: 1285-1294
• 2 Haidl P, Pohlmann G, Cloes RM. Power requirements of pMDI and DPI’s. J Aerosol Med Pulm Drug Deliv 2015; 28: A 22
• 3 Ninane V, Vandevoorde J, Cataldo D et al. New developments in inhaler devices within pharmaceutical companies: a systematic review of the impact of clinical outcomes and patient preferences. Respir Med 2015; 109: 1430-1438
• 4 Pasqual S, Feimer J, De Soyza A et al. Preference, satisfaction and critical errors with Genuair and Breezhaler inhalers in patients with COPD: a randomized, cross-over, multicentre study. Prim Care Respir Med 2015; 25: 15018
• 5 Svedsater H, Dale P, Garrill K et al. Qualitative assessment of attributes and ease of use of the Ellipta™ dry powder inhaler for delivery of maintenance therapy for asthma and COPD. BMC Pulm Med 2013; 13: 72-86
• 6 Voshaar T, Spinola M, Linnnane P et al. Comparing usability of NEXThaler^® with other inhaled corticosteroid / long-acting β2-agonist fixed combination dry powder inhalers in asthma patients. J Aerosol Med Pulm Drug Deliv 2014; 27: 363-370
• 7 Crompton GK, Barnes PJ, Broeder M et al. The need to improve inhalation technique in Europe: a report from the Aerosol Drug Management Improvement Team. Respir Med 2006; 100: 1479-1494
• 8 Lavorini F, Fontana GA, Usmani OS. New inhaler devices – the good, the bad and the ugly. Respiration 2014; 88: 3-15
• 9 Laube BL, Janssens HM, de Jongh FH et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J 2011; 37: 1308-1321
• 10 Knipel V, Criee CP, Windisch W. Korrekte Inhalationstherapie: Einweisung mittels Internet-verfügbarer Filmsequenzen. Eine Initiative der Deutschen Atemwegsliga. Pneumologie 2013; 67: 157-161
• 11 Bourbeau J, Barlett SJ. Patient adherence in COPD. Thorax 2008; 63: 831-838
• 12 Bjermer L. The importance of continuity in inhaler device choice for asthma and OPD. Respiration 2014; 88: 346-352
• 13 Chrystyn H, Small M, Milligan G et al. Impact of patient’s satisfaction with their inhalers on treatment compliance and health status in COPD. Respir Med 2014; 108: 358-365