The influence of inhaler selection on efficacy of asthma therapies

Adv Drug Deliv Rev. 2003 Jul 18;55(7):879-923. doi: 10.1016/s0169-409x(03)00083-8.


Many different devices are available to aid inhalational drug delivery. Although each device is claimed to have advantages over its rivals, the evidence to support greater efficacy of a particular device is scanty. Most comparative studies are underpowered or flawed in their design. They may use inappropriate end-points, or involve healthy subjects, whose response may be very different from the patient with acute severe asthma. The dosage of drug used in a trial may be at the shallow part of the dose-response curve, masking differences in devices. Only in a few cases have clinical trials detected a significant difference between devices, and trials have rarely taken patient preference into account. The most efficacious device in practice is likely to be the one that the patient will use regularly and in accordance with a health care workers' recommendations.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Administration, Inhalation
  • Anti-Asthmatic Agents / administration & dosage*
  • Asthma / drug therapy*
  • Equipment Design
  • Humans
  • Metered Dose Inhalers*


  • Anti-Asthmatic Agents