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P221 Comparing the perception of feed-back mechanism of the breezhaler® device with the ellipta® device in patients with chronic obstructive pulmonary disease (COPD): the advantage study
  1. P Altman1,
  2. MA Bergna2,
  3. GR Garcia3,
  4. K Kostikas4,
  5. T Guerin5,
  6. AV Pino6,
  7. J Whiteford5
  1. 1Novartis Pharmaceuticals Corporation, East Hanover, USA
  2. 2Respiratory Research, CEMER Centro Médico de Enfermedades Respiratorias, Vicente López, Argentina
  3. 3Pneumology, Cenasma Institute, La Plata, Argentina
  4. 4Novartis Pharma AG, Basel, Switzerland
  5. 5Novartis Ireland Limited, Dublin, Ireland
  6. 6Novartis Argentina S.A., Buenos Aires, Argentina


Background and aims Patient preference and satisfaction with inhalers are important factors that may impact adherence to treatment and hence its outcome.1 The ADVANTAGE study compared the Breezhaler® and the Ellipta® inhalers for patient perception of feedback mechanism and the comfort of the mouth piece, in COPD patients, naïve to dry powder inhaler use.

Methods This open-label cross-over study randomised (1:1) patients (≥40 years) with COPD [all severities as per GOLD 2014] and smoking history of ≥10 pack-years to use both the Breezhaler® and Ellipta® devices in differing sequences with a separation of ≥5 minutes between devices. After inhalation, patients completed a questionnaire2 containing 4 questions that captured patients’ perception of the feedback mechanism (mean of first three questions) and comfort of the mouth piece (fourth question). Questions were answered on a scale of 1 (lower preference) to 5 (higher preference), a Wilcoxon signed rank test was performed to test the difference between devices at a 2-sided 2.5% level of significance for both endpoints. Safety assessments included adverse events, physical examination, vital signs, height and weight.

Results One hundred patients (64 men and 36 women) with a mean (SD) age of 65.2 (9.07) years were randomised to inhale sequentially through both devices. Thirty two patients were current smokers and had a mean (SD) duration of COPD for 6.1 (4.82) years. Overall, patients perceived that the Breezhaler® inhaler offered greater confidence of dose delivery and better comfort of the mouth piece (mean (SD) score 4.3 (0.70) and 4.3 (0.82); respectively) vs. the Ellipta® inhaler [mean (SD) score 3.6 (1.05) and 3.9 (0.84); respectively] (Figure). No safety signals were identified during the study.

Conclusions In this study, COPD patients had greater confidence of receiving full dose with the Breezhaler® device and better comfort with the mouth piece compared with the Ellipta® device.


  1. Anderson PJ. Eur Respir Rev 2005;14(96):109–116.

  2. Altman P, et al. Prim Care Respir Med 2016;26:CR052.

Abstract P221 Figure 1

Mean Scores of the analysis of patients preference of the Breezhaler and the Ellipta devices

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