Tobramycin inhalation powder for the treatment of pulmonary Pseudomonas aeruginosa infection in patients with cystic fibrosis: a review based on clinical evidence

Abstract

Chronic airway infection with Pseudomonas aeruginosa is a major cause of increased morbidity and mortality in patients with cystic fibrosis (CF). The development and widespread use of nebulized antibacterial therapies, including tobramycin inhalation solution (TIS), has led to improvements in lung function and quality of life. However, the use of nebulizers is associated with various challenges, including extended administration times and the need for frequent device cleaning and disinfection. Multiple therapies are required for patients with CF, which poses a considerable burden to patients, and adherence to the recommended treatments remains a challenge. Tobramycin inhalation powder (TIP), delivered via the T-326 Inhaler, has been shown to have similar clinical efficacy and safety as compared to TIS, with improved patient convenience, satisfaction, and treatment adherence. Long-term safety studies have shown that TIP was well tolerated with no unexpected adverse events in patients with CF. This review of the TIP pivotal and postmarketing studies reinforces the well-established efficacy and safety profile of TIP and its ease of use.

Keywords: Pseudomonas aeruginosa; cystic fibrosis; equipment contamination; nebulizers and vaporizers; patient compliance; patient preference; tobramycin.

Figure 1.

(a) Scanning electron microscopic image of typical micronized drug particles, TIP particles, and TIP particle (close up) and (b) T-326 Inhaler for use with TIP (TOBI^® Podhaler™) (images included with permission from Geller et al.). TIP, tobramycin inhalation powder.

Figure 2.

Overview of phase III and IV studies and evaluated endpoint. ITA-CFq, Italian Treatment Adherence Cystic Fibrosis Questionnaire; CFQ-R, cystic fibrosis questionnaire: revised scale; TIP, tobramycin inhalation powder.