A few studies have assessed the ability of patients with COPD to use various DPIs devices. It appears that pts with severe COPD, elderly pts, pts with muscle fatigue and COPD pts during exacerbations, may have problems in achieving a minimum required inspiratory flow rate through DPIs, to get the dose to the airways. In order to achieve the most effective treatment in COPD patients we have explored the impact of personalized treatment comparing the values of FEV1, FVC, PIF before and after treatment with indacaterol through a device from the market (MD) of low resistance (R?96 L/min) in comparison with a new device (Pandora, PD - US 11,439,776 B2) with three settable resistances (R1, R2, R3) according to the inspiratory value generated by the patient.

Fifty COPD pts with stable diseases up to 70 years old, FEV1 ? 80% included in the study. All pts performed PIF, FEV1, FVC before and after treatment with indacaterol at 3, 8, 15, 30, 60 minutes: Group A-25 pts through the MD, Group B-25 pts through PD device. Each Group repeated the examination after 48 hours, switching devices.

No statistically significant differences were found between the MD and PD DPIs (R1?100 L/min) in FEV1 and FVC in pts with PIF ? 40 L/min. In pts with 40 L/min < PIF ? 65 L/min there was a limited statistical difference in favor of PD (R2?84 L/min). Statistically significant differences were found in pts with PIF > 65 L/min in favor of PD and R3?62 L/min. 

The study is still in progress. The results are suggesting a possible superiority of personalized treatment in COPD pts with an adjustable inner resistances device, according to the initial PIF.