Abstract
Dosing performance of dry powder inhalers is dependent on patient's inspiratory effort. This study compares the inhalation profiles generated by patients with severe obstructive lung disease using DiskusTMand TurbuhalerTMinhalers. The patient profiles are subsequently used to determine the dosing performance of fluticasone propionate DiskusTMand budesonide TurbuhalerTMinhalers.Inhalation profiles were recorded in COPD patients (FEV1≤30% predicted) as they inhaled with maximal effort through the inhalers. The profiles were used in an inhalation simulator to assess the dosing performance by measuring the total emitted dose and the fine particle mass for each inhaler type.Peak inspiratory flow was significantly higher through the DiskusTM(mean 82·3 l min−1) compared with TurbuhalerTM(mean 53·5 l min−1, difference = 28.8 l min−1;P<0·0001). In addition, in direct comparison of the two devices, the DiskusTMwas shown to deliver a more consistent dose irrespective of flow than the TurbuhalerTMin this patient population. These findings may be of importance in optimising selection of devices for patients with severe airway obstruction.
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