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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">pulmo</journal-id><journal-title-group><journal-title xml:lang="ru">Пульмонология</journal-title><trans-title-group xml:lang="en"><trans-title>PULMONOLOGIYA</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0869-0189</issn><issn pub-type="epub">2541-9617</issn><publisher><publisher-name>Scientific and Practical Journal “PULMONOLOGIYA” LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18093/0869-0189-2016-26-4-498-504</article-id><article-id custom-type="elpub" pub-id-type="custom">pulmo-751</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW</subject></subj-group></article-categories><title-group><article-title>ДуоРесп Спиромакс® – новый интуитивный дозирующий порошковый ингалятор будесонида и формотерола</article-title><trans-title-group xml:lang="en"><trans-title>DuoResp Spiromax® is a new intuitive dosing dry powder inhaler of budesonide and formoterol</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Визель</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Vizel'</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д. м. н., профессор, зав. кафедрой фтизиопульмонологии ГБОУ ВПО «Казанский государственный медицинский университет» Минздрава России; тел.: (9872) 96-25-99;</p></bio><bio xml:lang="en"><p>MD, Professor, Head of Department of Phthisiology and Pulmonology, Kazan State Medical University, Healthcare Ministry of Russia; tel.: (9872) 96-25-99;</p></bio><email xlink:type="simple">lordara@inbox.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Визель</surname><given-names>И. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Vizel'</surname><given-names>I. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к. м. н., профессор РАЕ, ассистент кафедры фтизиопульмонологии ГБОУ ВПО «Казанский государственный медицинский университет» Минздрава России; тел.: (9872) 96-25-99;</p></bio><bio xml:lang="en"><p>PhD, Assistant Lecturer at the Department of Phthisiology and Pulmonology, Kazan State Medical University, Healthcare Ministry of Russia; tel.: (9872) 96-25-99;</p></bio><email xlink:type="simple">tatpulmo@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБОУ ВПО «Казанский государственный медицинский университет» Минздрава России: 420012, Республика Татарстан, Казань, ул. Бутлерова, 49</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kazan State Medical University, Healthcare Ministry of Russia: 49, Butlerova str., Kazan', 420012, Tatarstan Republic</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2016</year></pub-date><pub-date pub-type="epub"><day>18</day><month>10</month><year>2016</year></pub-date><volume>26</volume><issue>4</issue><fpage>498</fpage><lpage>504</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Визель А.А., Визель И.Ю., 2016</copyright-statement><copyright-year>2016</copyright-year><copyright-holder xml:lang="ru">Визель А.А., Визель И.Ю.</copyright-holder><copyright-holder xml:lang="en">Vizel' A.A., Vizel' I.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.pulmonology.ru/pulm/article/view/751">https://journal.pulmonology.ru/pulm/article/view/751</self-uri><abstract><p>Представленный обзор литературы посвящен применению фиксированной комбинации будесонида и формотерола в лечении бронхообструктивной патологии. Положительный эффект этой комбинации при хронической обструктивной болезни легких (ХОБЛ) и бронхиальной астме (БА) имеет высокий уровень доказательности. Одной из проблем в достижении клинического эффекта ингаляционной терапии является корректность применения дозирующего ингалятора. Представлена информация о новом дозирующем порошковом ингаляторе ДуоРесп Спиромакс®, простота применения которого близка к интуитивной. По результатам сравнительных исследований показано, что применение ДуоРесп Спиромакс® позволит повысить эффективность терапии и снизить затраты здравоохранения на лечение ХОБЛ и БА.</p></abstract><trans-abstract xml:lang="en"><p>A review of efficacy of budesonide/formoterol fixed combination in obstructive lung diseases has been done in the article. The efficacy of this combination in chronic obstructive pulmonary disease (COPD) and asthma has been supported by high-level evidence. Clinical effect of inhalation therapy depends on proper use of the inhaler. Information on a new dosing dry powder inhaler DuoResp Spiromax® is given in the review. The ease of use of this inhaler is close to intuitive use. According to comparative trials, DuoResp Spiromax® is a promising inhaler which could improve the therapeutic efficacy and reduce cost of treatment of COPD and asthma.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>формотерол</kwd><kwd>будесонид</kwd><kwd>дозирующий порошковый ингалятор</kwd><kwd>ДуоРесп Спиромакс®</kwd></kwd-group><kwd-group xml:lang="en"><kwd>formoterol</kwd><kwd>budesonide</kwd><kwd>dosing dry powder inhaler</kwd><kwd>DuoResp Spiromax®</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Chuchalin A.G., Khaltaev N., Antonov N.S. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int. J. Chron. Obstruct. Pulm. Dis. 2014; 9: 963–974.</mixed-citation><mixed-citation xml:lang="en">Chuchalin A.G., Khaltaev N., Antonov N.S. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int. J. Chron. Obstruct. Pulm. Dis. 2014; 9: 963–974.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Adeloye D., Chua S., Lee C. et al. Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J. Glob. Health. 2015; 5 (2): 020415.</mixed-citation><mixed-citation xml:lang="en">Adeloye D., Chua S., Lee C. et al. Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J. Glob. Health. 2015; 5 (2): 020415.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Braido F., Brusselle G., Guastalla D. et al. Determinants and impact of suboptimal asthma control in Europe: The international cross-sectional and longitudinal assessment on asthma control (LIAISON) study. Respir. Res. 2016; 17 (1): 51.</mixed-citation><mixed-citation xml:lang="en">Braido F., Brusselle G., Guastalla D. et al. Determinants and impact of suboptimal asthma control in Europe: The international cross-sectional and longitudinal assessment on asthma control (LIAISON) study. Respir. Res. 2016; 17 (1): 51.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Global initiative for asthma (GINA). A pocket guide for health professionals: Updated 2016.</mixed-citation><mixed-citation xml:lang="en">Global initiative for asthma (GINA). A pocket guide for health professionals: Updated 2016.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (GOLD): Updated 2016.</mixed-citation><mixed-citation xml:lang="en">Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (GOLD): Updated 2016.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Baker J.G. The selectivity of beta-adrenoceptor agonists at human beta1-, beta2- and beta3-adrenoceptors. Br. J. Pharmacol. 2010; 160 (5): 1048–1061.</mixed-citation><mixed-citation xml:lang="en">Baker J.G. The selectivity of beta-adrenoceptor agonists at human beta1-, beta2- and beta3-adrenoceptors. Br. J. Pharmacol. 2010; 160 (5): 1048–1061.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Willey R.F., Godden D.J., Carmichael J. et al. Comparison of twice daily administration of a new corticosteroid budesonide with beclomethasone dipropionate four times daily in the treatment of chronic asthma. Br. J. Dis. Chest. 1982; 76 (1): 61–68.</mixed-citation><mixed-citation xml:lang="en">Willey R.F., Godden D.J., Carmichael J. et al. Comparison of twice daily administration of a new corticosteroid budesonide with beclomethasone dipropionate four times daily in the treatment of chronic asthma. Br. J. Dis. Chest. 1982; 76 (1): 61–68.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Lähelmä S., Sairanen U., Haikarainen J. et al. Equivalent lung dose and systemic exposure of budesonide/formoterol combination via Easyhaler and Turbuhaler. J. Aerosol. Med. Pulm. Drug Deliv. 2015; 28 (6): 462–473.</mixed-citation><mixed-citation xml:lang="en">Lähelmä S., Sairanen U., Haikarainen J. et al. Equivalent lung dose and systemic exposure of budesonide/formoterol combination via Easyhaler and Turbuhaler. J. Aerosol. Med. Pulm. Drug Deliv. 2015; 28 (6): 462–473.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Latorre M., Novelli F., Vagaggini B. et al. Differences in the efficacy and safety among inhaled corticosteroids (ICS) / long-acting beta2-agonists (LABA) combinations in the treatment of chronic obstructive pulmonary disease (COPD): Role of ICS. Pulm. Pharmacol. Ther. 2015; 30: 44–50.</mixed-citation><mixed-citation xml:lang="en">Latorre M., Novelli F., Vagaggini B. et al. Differences in the efficacy and safety among inhaled corticosteroids (ICS) / long-acting beta2-agonists (LABA) combinations in the treatment of chronic obstructive pulmonary disease (COPD): Role of ICS. Pulm. Pharmacol. Ther. 2015; 30: 44–50.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Hozawa S., Terada M., Haruta Y., Hozawa M. Comparison of early effects of budesonide/formoterol maintenance and reliever therapy with fluticasone furoate/vilanterol for asthma patients requiring step-up from inhaled corticosteroid monotherapy. Pulm. Pharmacol. Ther. 2016; 37: 15–23.</mixed-citation><mixed-citation xml:lang="en">Hozawa S., Terada M., Haruta Y., Hozawa M. Comparison of early effects of budesonide/formoterol maintenance and reliever therapy with fluticasone furoate/vilanterol for asthma patients requiring step-up from inhaled corticosteroid monotherapy. Pulm. Pharmacol. Ther. 2016; 37: 15–23.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Kew K.M., Karner C., Mindus S.M., Ferrara G. Combination formoterol and budesonide as maintenance and reliever therapy versus combination inhaler maintenance for chronic asthma in adults and children. Cochrane Database Syst. Rev. 2013; 12: CD009019.</mixed-citation><mixed-citation xml:lang="en">Kew K.M., Karner C., Mindus S.M., Ferrara G. Combination formoterol and budesonide as maintenance and reliever therapy versus combination inhaler maintenance for chronic asthma in adults and children. Cochrane Database Syst. Rev. 2013; 12: CD009019.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Ekberg-Jansson A., Svenningsson I., Rågdell P. et al. Budesonide inhaler device switch patterns in an asthma population in Swedish clinical practice (ASSURE). Int. J. Clin. Pract. 2015; 69 (10): 1171–1178.</mixed-citation><mixed-citation xml:lang="en">Ekberg-Jansson A., Svenningsson I., Rågdell P. et al. Budesonide inhaler device switch patterns in an asthma population in Swedish clinical practice (ASSURE). Int. J. Clin. Pract. 2015; 69 (10): 1171–1178.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Scichilone N., Benfante A., Bocchino M. et al. Which factors affect the choice of the inhaler in chronic obstructive respiratory diseases? Pulm. Pharmacol. Ther. 2015; 31: 63–67.</mixed-citation><mixed-citation xml:lang="en">Scichilone N., Benfante A., Bocchino M. et al. Which factors affect the choice of the inhaler in chronic obstructive respiratory diseases? Pulm. Pharmacol. Ther. 2015; 31: 63–67.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Cohen J.S., Miles M.C., Donohue J.F., Ohar J.A. Dual therapy strategies for COPD: the scientific rationale for LAMA + LABA. Int. J. Chron. Obstruct. Pulm. Dis. 2016; 11: 785–797.</mixed-citation><mixed-citation xml:lang="en">Cohen J.S., Miles M.C., Donohue J.F., Ohar J.A. Dual therapy strategies for COPD: the scientific rationale for LAMA + LABA. Int. J. Chron. Obstruct. Pulm. Dis. 2016; 11: 785–797.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Laube B.L., Janssens H.M., de Jongh F.H.C. et al. What the pulmonary specialist should know about the new inhalation therapies: ERS/ISAM task force report. Eur. Respir. J. 2011; 37 (6): 1308–1331.</mixed-citation><mixed-citation xml:lang="en">Laube B.L., Janssens H.M., de Jongh F.H.C. et al. What the pulmonary specialist should know about the new inhalation therapies: ERS/ISAM task force report. Eur. Respir. J. 2011; 37 (6): 1308–1331.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Wilson D.S., Gillion M.S., Rees P.J. Use of dry powder inhalers in COPD. Int. J. Clin. Pract. 2007; 61 (12): 2005–2008.</mixed-citation><mixed-citation xml:lang="en">Wilson D.S., Gillion M.S., Rees P.J. Use of dry powder inhalers in COPD. Int. J. Clin. Pract. 2007; 61 (12): 2005–2008.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Wieshammer S., Dreyhaupt J. Dry powder inhalers: Which factors determine the frequency of handling errors? Respiration. 2008; 75:1 8–25.</mixed-citation><mixed-citation xml:lang="en">Wieshammer S., Dreyhaupt J. Dry powder inhalers: Which factors determine the frequency of handling errors? Respiration. 2008; 75:1 8–25.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Melani A.S., Bonavia M., Cilenti V. et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir. Med. 2011; 105 (6): 930–938.</mixed-citation><mixed-citation xml:lang="en">Melani A.S., Bonavia M., Cilenti V. et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir. Med. 2011; 105 (6): 930–938.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Basheti I.A., Obeidat N.M., Ammari W.G., Reddel H.K. Associations between inhaler technique and asthma control among asthma patients using pressurised MDIs and DPIs. Int. J. Tuberc. Lung Dis. 2016; 20 (5): 689–695.</mixed-citation><mixed-citation xml:lang="en">Basheti I.A., Obeidat N.M., Ammari W.G., Reddel H.K. Associations between inhaler technique and asthma control among asthma patients using pressurised MDIs and DPIs. Int. J. Tuberc. Lung Dis. 2016; 20 (5): 689–695.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Kondo T., Tanigaki T., Hibino M. et al. Resistances of dry powder inhalers and training whistles and their clinical significance. Arerugi. 2014; 63 (10): 1325–1329.</mixed-citation><mixed-citation xml:lang="en">Kondo T., Tanigaki T., Hibino M. et al. Resistances of dry powder inhalers and training whistles and their clinical significance. Arerugi. 2014; 63 (10): 1325–1329.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Wolthers O.D., Shah T.A Comparison of short-term growth during treatment with two dry powder combinations of inhaled corticosteroids and long-acting β₂-agonists. J. Aerosol Med. Pulm. Drug Deliv. 2015; 28 (3): 182–188.</mixed-citation><mixed-citation xml:lang="en">Wolthers O.D., Shah T.A Comparison of short-term growth during treatment with two dry powder combinations of inhaled corticosteroids and long-acting β₂-agonists. J. Aerosol Med. Pulm. Drug Deliv. 2015; 28 (3): 182–188.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Canonica G.W., Arp J., Keegstra J.R., Chrystyn H. Spiromax, a new dry powder inhaler: dose consistency under simulated real-world conditions. J. Aerosol. Med. Pulm. Drug Deliv. 2015; 28 (5): 309–319.</mixed-citation><mixed-citation xml:lang="en">Canonica G.W., Arp J., Keegstra J.R., Chrystyn H. Spiromax, a new dry powder inhaler: dose consistency under simulated real-world conditions. J. Aerosol. Med. Pulm. Drug Deliv. 2015; 28 (5): 309–319.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Virchow J.C., Rodriguez-Roisin R., Papi A. et al. A randomized, double-blinded, double-dummy efficacy and safety study of budesonide-formoterol Spiromax® compared to budesonide-formoterol TurbuhalerR in adults and adolescents with persistent asthma. BMC Pulm. Med. 2016; 16: 42.</mixed-citation><mixed-citation xml:lang="en">Virchow J.C., Rodriguez-Roisin R., Papi A. et al. A randomized, double-blinded, double-dummy efficacy and safety study of budesonide-formoterol Spiromax® compared to budesonide-formoterol TurbuhalerR in adults and adolescents with persistent asthma. BMC Pulm. Med. 2016; 16: 42.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Azouz W., Chetcuti P., Hosker H. et al. Inhalation characteristics of asthma patients, COPD patients and healthy volunteers with the Spiromax#R and Turbuhaler® devices: a randomised, cross-over study. BMC Pulm. Med. 2015; 15: 47.</mixed-citation><mixed-citation xml:lang="en">Azouz W., Chetcuti P., Hosker H. et al. Inhalation characteristics of asthma patients, COPD patients and healthy volunteers with the Spiromax#R and Turbuhaler® devices: a randomised, cross-over study. BMC Pulm. Med. 2015; 15: 47.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Plusa T. Pijos P. Features of the ideal inhaler in testing a new inhaler devices. Int. Rev, Allergol. Clin. Immunol. Familiy Med., 2015; 21 (1): 21–24.</mixed-citation><mixed-citation xml:lang="en">Plusa T. Pijos P. Features of the ideal inhaler in testing a new inhaler devices. Int. Rev, Allergol. Clin. Immunol. Familiy Med., 2015; 21 (1): 21–24.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Sandler N., Holländer J., Långström D. et al. Evaluation of inhaler handling-errors, inhaler perception and preference with Spiromax, Easyhaler and Turbuhaler devices among healthy Finnish volunteers: a single site, single visit crossover study (Finhaler). Br. Med. J. Open Respir. Res. 2016; 3 (1): e000119.</mixed-citation><mixed-citation xml:lang="en">Sandler N., Holländer J., Långström D. et al. Evaluation of inhaler handling-errors, inhaler perception and preference with Spiromax, Easyhaler and Turbuhaler devices among healthy Finnish volunteers: a single site, single visit crossover study (Finhaler). Br. Med. J. Open Respir. Res. 2016; 3 (1): e000119.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Chrystyn H., Safioti G., Keegstra J.R., Gopalan G. Effect of inhalation profile and throat geometry on predicted lung deposition of budesonide and formoterol (BF) in COPD: An in-vitro comparison of Spiromax with Turbuhaler. Int. J. Pharm. 2015; 491 (1–2): 268–276.</mixed-citation><mixed-citation xml:lang="en">Chrystyn H., Safioti G., Keegstra J.R., Gopalan G. Effect of inhalation profile and throat geometry on predicted lung deposition of budesonide and formoterol (BF) in COPD: An in-vitro comparison of Spiromax with Turbuhaler. Int. J. Pharm. 2015; 491 (1–2): 268–276.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Torvinen S., Nicolai J., Pulimeno S. et al. The budget impact of Duoresp® Spiromax® compared with commonly prescribed dry powder inhalers for the management of asthma and chronic obstructive pulmonary disease in Italy: estimated impact of inhalation technique. Value Health. 2015; 18 (7): A496.</mixed-citation><mixed-citation xml:lang="en">Torvinen S., Nicolai J., Pulimeno S. et al. The budget impact of Duoresp® Spiromax® compared with commonly prescribed dry powder inhalers for the management of asthma and chronic obstructive pulmonary disease in Italy: estimated impact of inhalation technique. Value Health. 2015; 18 (7): A496.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
