Respimat® (a New Soft Mist Inhaler) Delivering Fenoterol plus Ipratropium Bromide Provides Equivalent Bronchodilation at Half the Cumulative Dose Compared with a Conventional Metered Dose Inhaler in Asthmatic Patients
- 1 June 2000
- journal article
- clinical trial
- Published by S. Karger AG in Respiration
- Vol. 67 (3) , 306-314
- https://doi.org/10.1159/000029515
Abstract
Background: Respimat®, a possible alternative to the conventional metered dose inhaler (MDI), is a novel, reusable, propellant-free, multidose soft mist inhaler. Respimat slowly releases a metered dose of active substance as a soft mist with a high proportion of the dose in the fine particle fraction, leading to improved lung deposition following inhalation when compared with the conventional MDI. Objectives and Methods: The equipotent bronchodilating efficacy and safety of a combination of fenoterol hydrobromide and ipratropium bromide (F/I) in cumulative doses delivered by either Respimat or pressurised MDI was assessed in a randomised, controlled, double-blind (within device) 4-way crossover study. Forty-three patients with stable asthma (mean FEV1 62% predicted) responsive to F/I inhaled cumulatively 16 puffs on each of 4 test days (1 + 1 + 2 + 4 + 8 puffs at 50-min intervals) via Respimat delivering 50/20, 25/20 or 25/10 µg F/I per puff or via MDI delivering 50/20 µg F/I per puff. Results: Cumulative doses of 400/160 and 400/320 µg F/I via Respimat produced bronchodilation (evaluated by average increase in FEV1 45–245 min after first inhalation) equivalent to that achieved with a cumulative 800/320 µg F/I via MDI (mean increase in FEV1 above baseline 0.76, 0.73 and 0.71 litres, respectively). The tolerability of the F/I combination via Respimat was also comparable to that of twice the dose delivered via MDI. Conclusion: Therefore, a fenoterol hydrobromide/ipratropium bromide combination delivered by Respimat is as safe and effective as the MDI at half the cumulative dose, on acute administration to patients with asthma.Keywords
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