Usability of Levodopa Cyclops ® Compared to INBRIJA ® During an off Episode in Parkinson’s Disease Patients

Background: This study compares the usability of two levodopa dry powder inhalers. The Inbrija ® inhaler involves several preparatory steps, including blister opening and capsule insertion. The Cyclops ® inhaler is preloaded and disposable, designed for immediate use. Ease of use is critical, as cognitive and motor impairments may hinder the patients’ ability to operate an inhaler. Methods: Sixteen patients with Parkinson’s disease experiencing predictable and recognizable off episodes were enrolled. After receiving inhalation instructions, patients performed the inhalation maneuver during their off-episode to assess the correct execution. They completed a questionnaire evaluating the ease of use for both devices. Each patient used both the Cyclops ® and Inbrija ® inhalers in a randomized sequence and completed the questionnaire. Results: All 16 patients correctly performed the Cyclops ® inhaler steps during an off episode, while only 10 patients successfully completed the steps with the Inbrija ® inhaler. Twelve of the sixteen patients (75%) expressed a preference for the Cyclops ® , rating it higher in terms of ease of use and hygiene. However, concerns were raised regarding the environmental sustainability of its single-use design. For the Inbrija ® , patients reported difficulties with opening the peel-off blister packaging, assembling the mouthpiece, and puncturing the capsules. Conclusion: The Cyclops ® inhaler was more user-friendly during off episodes due to its ease of use and simpler handling. Since the Cyclops ® is preloaded, it requires fewer and simpler steps. The preparation steps of Inbrija ® posed usability challenges, particularly with opening the peel-off blister packaging of the capsule and assembling the mouthpiece and handle.