ASK DIS: 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:

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