Table 2.
Clinical trials of nebulizers vs. inhalers that included patient-reported outcomes
| First author, year | Study type | Sample and comparison | Study findings |
|---|---|---|---|
| Jenkins, 1987 [39] | 8-week crossover trial |
19 with stable chronic airflow limitation (number with COPD not stated) Albuterol via pMDI vs. nebulizer |
No statistical difference in daily peak expiratory flow (PEFR), severity of symptoms, extra bronchodilator use, or exercise tolerance All patients attributed an improvement in their symptoms to the nebulizers |
| O’Driscoll, 1992 [40] | Clinical trial of usual inhaler treatment followed by nebulizer treatment | 34 with COPD | Approximately half of patients who remained breathless despite receiving bronchodilators delivered by pMDIs or DPIs derived additional benefits from home nebulizer use; the majority of patients with COPD in this study chose to remain on nebulizers for long-term therapy |
| Balzano, 2000 [18] | 2-week crossover trial |
12 with COPD, 8 with asthma (combined in analyses) Multidrug combination of 600 vs. 1875 μg of albuterol, 120 vs. 375 μg of ipratropium bromide, and 1000 vs. 3000 μg of flunisolide via pMDI and nebulizer, respectively |
A 19% greater change in FEV1 after treatment with nebulizers compared with inhalers was not statistically significant The majority (75%) of participants considered treatment more effective with nebulizers than with inhalers |
| Tashkin, 2007 [41] | 12-week randomized clinical trial of patients comparing inhalers, nebulizers, and concomitant therapy |
126 with COPD Albuterol plus ipratropium via nebulizer, inhaler, or both |
Nebulizers showed better patient-reported outcomes including questionnaire symptoms and quality of life; peak flow and FEV1 showed no significant differences; concomitant therapy was better than either alone |
| Brophy, 2008 [42] | Crossover trial |
25 with COPD 120 mcg ipratropium bromide and 600 mcg of albuterol via pMDI with spacer vs. 500 mcg ipratropium bromide and 2.5 mg albuterol via nebulizer |
No statistical difference in measures of lung function, 6-min walk distance, breathlessness score, or qualify of life score 60% of patients reported a preference for nebulizers |