Switching Tiotropium Handihaler to Respimat Soft Mist
- Tiotropium
(Spiriva) is licensed as a maintenance bronchodilator treatment to relieve
symptoms of COPD.
- Tiotropium can be
delivered in two ways:
- via the HandiHaler
inhaler once daily, from a capsule containing 18 micrograms of tiotropium
- via the soft-mist
Respimat inhaler taken as two puffs once daily (2.5 micrograms of
tiotropium delivered per puff)
Efficacy
- In
Japanese patients with COPD, tiotropium Respimat® 5 μg and
tiotropium HandiHaler® 18 μg showed a similar profile of
efficacy, safety and pharmacokinetics
- There was
a study showed that no major problem in switching from Tiotropium
Handihaler to Respimat. Respimat and Handihaler showed similar effects and
usability.
Adverse
Events
- risk for mortality in chronic
obstructive pulmonary disease (COPD) patients being treated with
tiotropium is the same whether the drug is delivered by the Respimat
Soft Mist Inhaler or the HandiHaler device, a large, long-term study has
found
- In the 17,000 COPD patients
followed for more than 2 years, there were no statistically significant
differences in rates of mortality, myocardial infarction, or stroke
between the 2 tiotropium delivery systems
- the finding is in direct contrast
to those from smaller investigations that have questioned the safety of
tiotropium delivered by the Respimat device
Technique
- in general, both inhalers were
considered to be easy to use
- The Respimat reportedly has high
levels of satisfaction in COPD patients, due to its inhalation and
handling characteristics
- The preference for the Respimat
increased with continued use.
References:
- https://www.gov.uk/drug-safety-update/tiotropium-delivered-via-respimat-compared-with-handihaler-no-significant-difference-in-mortality-in-tiospir-trial
- http://www.ncbi.nlm.nih.gov/pubmed/22691112
- http://reference.medscape.com/drug/spiriva-handihaler-spiriva-respimat-tiotropium-343446
- http://www.medscape.com/viewarticle/811257#vp_1
- http://www.resmedjournal.com/article/S0954-6111%2809%2900375-8/abstract
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293296/
- http://bmjopen.bmj.com/content/5/5/e006619.full
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