Page 18 - JCTR-9-5

320 Ji et al. | Journal of Clinical and Translational Research 2023; 9(5): 317-321
400 µg. Other doses of salbutamol and other bronchodilators
should be studied in future studies.
This study may impact clinical practice since the previously
non-validated Dosivent chamber showed similar performance to
®
another commonly used inhalation chamber, and it seems more
satisfactory for users.
5. Conclusions

The Dosivent chamber demonstrated excellent agreement
®
with the Aerochamber Plus Flow-Vu in terms of the increase in
®
®
FEV1 and FVC during a bronchodilator test. Therefore, in routine
clinical practice, it is viable to use both chambers interchangeably
contingent on the preferences of the patient and professional.
Acknowledgments

Figure 3. Bland-Altman plot representing concordance between None.
forced vital capacity increase with Aerochamber Plus Flow Vu and
®
®
Dosivent . Funding
®
This research was funded by Reiner Medical.
In addition, we observed that the bronchial response to salbutamol
was reproducible over a 2-day period. Conflicts of Interest
In the literature, few comparative studies exist between different
chambers, and no previous study has included Dosivent . Most, like L.P.-M. has received funding from GSK, Chiesi, and Sanofi
®
ours, have compared the increase in FEV1 after the administration and has received consulting fees from MSK. All other authors
have no conflicts of interest to declare.
of a bronchodilator through different devices [16-18]. Some have
also compared the FEV1 change with different chambers and the References
direct administration of the MDI [16]. We used the Aerochamber
Plus Flow-Vu for comparison because it is commonly used. It [1] Confalonieri M, Braga L, Salton F, Ruaro B, Confalonieri P.
®
®
has also been widely studied in patients of different ages, with Chronic Obstructive Pulmonary Disease Definition: Is
different respiratory diseases, and whose characteristics are well it Time to Incorporate the Concept of Failure of Lung
known both in vitro and in vivo with different inhalers [19-24]. We Regeneration? Am J Respir Crit Care Med 2023;207:366-7.
found excellent agreement according to the intraclass correlation [2] Miravitlles M, Kawayama T, Dreher M. LABA/LAMA
coefficient. The Bland–Altman plot also showed good agreement, as First-line Therapy for COPD: A Summary of the
with only 6% of the point outside the 95% confidence interval. Evidence and Guideline Recommendations. J Clin Med
We found no comparative study on the satisfaction of patients 2022;11:6623.
with different chambers. In our study, we found a slightly but [3] Sanders M. Inhalation Therapy: An Historical Review.
significantly higher FSI-10 score with the Dosivent relative to Prim Care Respir J 2007;16:71-81.
®
the Aerochamber Plus Flow-Vu . The FSI-10 questionnaire [4] Stein SW, Thiel CG. The History of Therapeutic Aerosols:
®
®
evaluates the subjective satisfaction of patients with inhalers A Chronological Review. J Aerosol Med Pulm Drug Deliv
and has been widely used for patients with different pulmonary 2017;30:20-41.
pathologies [25-27]. It was not specifically designed to evaluate [5] Rau JL. The Inhalation of Drugs: Advantages and Problems.
inhalation chambers, but its questions refer to the ease of use of Respir Care 2005;50:367-82.
the devices and chambers.
The main strength of our study is that we included patients with [6] Ivey JW, Vehring R, Finlay WH. Understanding Pressurized
both known and newly diagnosed diseases, as well as patients of Metered Dose Inhaler Performance. Expert Opin Drug
Deliv 2015;12:901-16.
both sexes, with and without baseline airflow obstruction.
Our study also has limitations. First, since it was not randomized, [7] Lexmond A, Forbes B. Drug Delivery Devices for Inhaled
it could have been influenced by the moment in which the tests Medicines. Handb Exp Pharmacol 2017;237:265-80.
were performed. However, only one patient had a negative BDR [8] Sorino C, Negri S, Spanevello A, Visca D, Scichilone N.
(different with each chamber), the washout procedure was similar Inhalation Therapy Devices for the Treatment of Obstructive
for the two tests, and the sessions were separated only by 2 days. Lung Diseases: The History of Inhalers Towards the Ideal
Second, the sample size did not allow sufficient statistical power Inhaler. Eur J Intern Med 2020;75:15-8.
to analyze the subgroups of participants. Third, we have only [9] Rogliani P, Calzetta L, Coppola A, Cavalli F, Ora J,
analyzed the change in FEV1 with the administration of salbutamol Puxeddu E, et al. Optimizing Drug Delivery in COPD: The
DOI: http://dx.doi.org/10.18053/jctres.09.202305.23-00081