Aerosol delivery of at least two liquid compositions

Abstract

The present invention relates to the field of liquid inhalation methods and devices. In particular, the present invention relates to an inhalation method using an inhalation device adapted to separately dispense at least two liquid compositions, each having different properties, and to a method for producing aerosols of at least two pharmaceutical formulations by means of such an inhalation device.

Description

[Technical Field]

[0001] The present invention relates to the field of inhalation devices for medically active liquids. In particular, the present invention relates to an inhalation device for generating an aerosol, the device comprising at least a first reservoir and a second reservoir containing a first liquid composition and a second liquid composition. [Background technology]

[0002] Nebulizers or other aerosol generators for liquids have long been known in the art. Such devices are used, inter alia, in medicine and therapy. There, they function as inhalation devices for administering active ingredients in the form of aerosols, i.e., small droplets embedded in a gas. Such inhalation devices are known, for example, from the literature, EP 0,627,230 B1. The essential components of such an inhalation device are a reservoir containing the liquid to be aerosolized, a pump unit for generating a pressure high enough to atomize the liquid, and an atomizing device in the form of a nozzle. A pump unit is defined as a unit or device component capable of moving or compressing a fluid material, comprising at least one pump chamber, and optionally further comprising auxiliary components such as a body, an interface, etc. The pump unit draws the liquid from the reservoir in discrete amounts, i.e., not continuously, and supplies it to the nozzle. The pump unit operates without a propellant and generates pressure mechanically.

[0003] A known embodiment of such an inhalation device is presented in the document WO 91 / 14468 A1. In such a device, pressure in a pump chamber connected to a housing is generated by the movement of a movable hollow piston. The piston is movably arranged in a stationary pump chamber. An inlet (arranged upstream) of the hollow piston is fluidly connected to the interior of a reservoir (reservoir pipe section). Its tip (arranged downstream) leads to the pump chamber. Furthermore, a check valve is arranged inside the tip of the piston to prevent backflow of liquid into the reservoir.

[0004] To fill the piston, its upstream end is directly connected to the reservoir. By withdrawing the piston from the pump chamber, its internal volume is expanded, resulting in an increasing relative negative pressure (i.e., partial vacuum) building up inside the pump chamber. This pressure is transmitted through the hollow piston to the reservoir, and liquid is drawn from the reservoir into the piston. At the same time, the valve opens at its tip, since the pressure in the reservoir is higher than in the (still empty) pump chamber. The pump chamber is being filled. At the same time, the spring is loaded and locked at the end of its movement, once the movable piston reaches its bottom dead center and the pump chamber is filled.

[0005] The spring can be manually unlocked, after which the stored energy is suddenly released. The piston is then pushed back into the pump chamber, thus reducing its internal volume. The aforementioned check valve now closes, preventing the liquid from flowing back into the reservoir, causing pressure to build up inside the pump chamber. This pressure ultimately causes the liquid to be ejected from a nozzle located at the downstream end of the pump chamber.

[0006] To face the risk of backflow of already released liquid or even ambient air, a further check valve, later called an outlet valve, can be placed at the downstream end of the pump chamber just before the nozzle, allowing the released liquid to pass but blocking the incoming gas.

[0007] The piston is placed inside a pressure spring designed as a helical spring, thus limiting its outer diameter, and due to the typically small volume (e.g., 15 μl), the piston is designed with a thin inner diameter (and often outer diameter as well).

[0008] The typically small inner diameter of the movable piston (e.g., 0.3 to 1.0 mm), along with the small size of the check valve disposed therein, is a drawback of the described structure. The small diameter results in high flow resistance, which makes it very slow for particularly high-viscosity media to flow into and pass through the piston. In other words, the described structure is particularly suitable for low-viscosity (aqueous) liquids and their low-dose delivery. Furthermore, it is difficult to manufacture a sufficiently tight check valve with a small diameter.

[0009] Another drawback of the described solutions is that only one type of liquid can be released at a time, i.e., depending on the contents of the reservoir. If a different liquid is to be aerosolized, the reservoir must be replaced and the nozzle must be cleaned from residues of the previous liquid before the inhaler can be used again.

[0010] European Patent No. 1,747,035 B1 discloses an inhalation device based on the above-mentioned technology, but with two separate reservoirs connected to two separate discharge nozzles via two separate pumping mechanisms. These nozzles can produce two separate sprays of the two liquids, or a single spray of the two liquids. However, the aforementioned drawbacks still apply. Furthermore, the inhalation device contains only one unit (e.g., a spring) that serves as the potential energy source for both the reservoirs and the pumping mechanism. As a result, the two dispensed liquids must have similar properties, such as viscosity, in order for the force required to expel the two liquids to be the same.

[0011] Inhalation therapy with two or more drugs is also known. In particular, triple combination therapy consisting of a long-acting muscarinic antagonist (LAMA), a long-acting beta-agonist (LABA), and an inhaled corticosteroid (ICS) has been developed to treat patients with chronic obstructive pulmonary disease (COPD). Typically, the components of LAMA and LABA are water-soluble, while the components of ICS are soluble in organic solvents and insoluble in aqueous solutions. Therefore, combining all three components into a single solution is impossible without precipitation of at least one of the components, requiring patients to use two or three different inhalers to dispense the liquid forms of the components. Alternatively, combined therapy in a single device has been limited to dry powders or powder suspensions due to the incompatibility of triple solution formulations of LAMA, LABA, and ICS.

[0012] It is an object of the present invention to provide an improved method for delivering liquid solutions having different properties and / or incompatible components to a patient by inhalation that overcomes one or more of the drawbacks of currently known inhalation therapies. A further object is to provide an inhalation device that enables such an improved delivery method. Further objects of the present invention will become apparent based on the following description of the invention, the examples, and the claims. [Prior art documents] [Patent documents]

[0013] [Patent Document 1] European Patent No. 0,627,230B1 [Patent Document 2] International Publication No. 91 / 14468A1 Brochure [Patent Document 3] European Patent No. 1,747,035B1 Summary of the Invention

[0014] In a first aspect, the present invention relates to an inhalation device for generating an aerosol, the device comprising at least a first reservoir and a second reservoir containing a first liquid composition and a second liquid composition, the inhalation device being a pump-actuated inhaler adapted to release metered doses of the first and second liquid compositions from the first and second reservoirs through a first and second outlet region upon activation of the first and second potential energy storage units. In another aspect, the present invention provides a first reservoir and a second reservoir adapted for use with an inhalation device as defined in the embodiments described herein.

[0015] In a further aspect, the present invention relates to an inhalation device as defined in the embodiments described herein according to the first aspect of the present invention for use in treating or preventing a disease or condition, in some embodiments a pulmonary disease or condition. In a still further aspect, the present invention provides an improved method of delivering at least two liquid compositions to a subject, whereby the above-described inhalation device is used to administer a first liquid composition and a second liquid composition having different properties and / or incompatible components. In a still further aspect, the present invention provides a method of treating a subject based on such an improved method of delivering at least two liquid compositions. DETAILED DESCRIPTION OF THE INVENTION

[0016] This object is achieved by the subject matter of the independent claims. Advantageous embodiments are set forth in the dependent claims, the subsequent description and the accompanying drawings.

[0017] We first provide definitions of some terms used throughout this specification and claims. The definitions should be used to determine the meaning of each expression unless the context requires a different meaning.

[0018] An "inhaler" or "inhaler device" or "inhalation device" is a device configured and adapted to produce an inhalable mist, vapor, or spray.

[0019] Terms such as "about" in connection with an attribute or value include the exact attribute or exact value, as well as any attribute or value that is normally considered to be within normal or accepted variability relevant to the technical field, and methods of measuring or determining said attribute or value.

[0020] "Atomization" and "nebulization," in the context of inhalers, refer to the production of fine, inhalable droplets of a liquid. Typical sizes of atomized droplets are in the range of a few microns.

[0021] An "aerosol" is a dispersion of a solid or liquid phase in a gas phase. The dispersed phase, also called the discontinuous phase, is composed of a plurality of solid or liquid particles. The aerosol produced by the inhalation device of the present invention is a dispersion of a liquid phase in the form of inhalable droplets in a gas phase, typically air. The dispersed liquid phase may optionally include solid particles dispersed in the liquid.

[0022] A "cartridge" is a unit containing one or more reservoirs that can be removed from a device and replaced when the reservoirs are empty. For example, a cartridge can contain one reservoir containing one liquid composition. Alternatively, a cartridge can contain at least two reservoirs, each containing a liquid composition, in one unit.

[0023] The "exit region" is the location where the liquid exits the inhaler device upon actuation of the device. Multiple exit regions may be included in a single nozzle unit. Alternatively, each exit region may be included in its own separate nozzle unit. Each exit region may have one or more channels for ejecting the liquid composition from the device. For example, an exit region may include only one channel, or may include at least two channels.

[0024] A "liquid" is a fluid material that can change its shape to the shape of a container that holds the liquid but maintains a nearly constant volume regardless of pressure. A liquid may refer to a single-phase liquid solution or a dispersion having a continuous liquid phase and a dispersed phase that may or may not be liquid.

[0025] "Plurality" means two or more.

[0026] "Internal" means inside, but can also mean inward-facing. "External" means outside, but can also mean outward-facing.

[0027] A "nozzle" is a unit that functions in atomizing / atomizing a liquid. Generally, this term refers to the entire unit. However, a nozzle can include one or more sets of individual, identical, or different subunits. A nozzle can have multiple ejection channels for ejecting the liquid compositions described herein.

[0028] The "major axis" of a nozzle is its central axis that is parallel to or collinear with the direction that most of the emitted aerosol travels after exiting the nozzle.

[0029] The "ejection trajectory" is an imaginary, relatively straight line that starts from the end of the ejection channel. This resembles the initial path of travel of the liquid ejected from the ejection channel when the suction device is operated. It is clear that the nozzle (and the entire suction device) must be adapted and configured, for example, by suitable channel geometry and sufficiently high pressure, so that the ejected liquid can be delivered in a sharp stream in said straight line.

[0030] When two or more ejecta trajectories intersect, a "collision point" is formed.

[0031] The term "metered dose" refers to an amount defined in terms of the volume (eg, μL, microliters) of liquid composition that can be expelled by an inhalation device as a result of a single (one) actuation of the device.

[0032] The term "single dose" with respect to a composition refers to the complete amount of a pharmacologically active composition administered to a subject at a dosing event and administered as part of a dosing regimen. As understood herein, a single dose may be administered to a subject via a single (one) actuation of an inhalation device, or it may also be administered over multiple actuations of an inhalation device, for example, two or three or four actuations of the device, according to prescribed usage, whereby the metered doses released with each individual actuation combine to provide the required single dose.

[0033] The term "comprising" and related terms "comprise" or "comprises" are understood to mean that features additional to the feature preceding the term may be present. Conversely, the term "consists" and related terms are understood to mean that no other features other than those listed preceding the term are present, and if present, are present only in minor or residual amounts that do not confer technical advantage or relevance for the purposes of the present invention.

[0034] Further definitions are provided in the ensuing discussion.

[0035] In a first aspect, the present invention provides an inhalation device for generating an aerosol of at least two liquid compositions, comprising at least first and second reservoirs containing at least a first and a second liquid composition, wherein the inhalation device is a pump-actuated inhaler adapted to, upon actuation, release a metered dose of the first liquid composition from the first reservoir and a metered dose of the second liquid composition from the second reservoir, wherein the first and second reservoirs for containing the first and second liquid compositions are fluidly connected to at least first and second pump chambers for generating a first pressure in the first pump chamber and a second pressure in the second pump chamber. the first and second riser pipes each receivable at the reservoir-facing inner ends of the first and second pump chambers, the internal volumes of the first and second pump chambers being changeable by relative movement of the first and second pump chambers with respect to the first and second riser pipes; at least a first outlet area and a second outlet area adapted to separately discharge the first and second liquid compositions from the inhalation device; a first potential energy storage unit coupled to one end of the first pump chamber; and a second potential energy storage unit coupled to one end of the second pump chamber.

[0036] The inhalation device according to the present invention is useful for generating aerosols of at least two liquid compositions (e.g., a first liquid composition and a second liquid composition), particularly aerosols that can be inhaled by a subject in need thereof, such as a warm-blooded animal or a human, particularly a human subject. Preferably, the inhalation device is suitable for being handheld and / or portable, and can be used by the individual subject themselves according to prescribed instructions. In some embodiments, the first reservoir and the second reservoir are incorporated into a single cartridge unit, or the first reservoir is incorporated into a first cartridge unit and the second reservoir is incorporated into a second cartridge unit. Such cartridge units can be removed from the device and replaced when the reservoirs are emptied after use.

[0037] The inhalation device is a pump-actuated inhaler, as understood herein, comprising at least two mechanically driven pump devices or units, each capable of moving or compressing a liquid and / or fluid, such as a first liquid composition and a second liquid composition, each having different properties and different active ingredients, additives, and / or excipients according to the present invention. In one embodiment of the present invention, the pump-actuated inhaler is a piston-pump-actuated inhaler having at least two piston pump systems and at least two potential energy storage units, each coupled to the piston pump systems.

[0038] A pump-actuated inhaler may include at least two pump devices or units, each coupled to a separate potential energy storage unit, that generate the desired pressure to release at least two compositions with different properties and active ingredients, additives, and / or excipients, e.g., in this embodiment, generate at least two aerosol streams via a first outlet region and a second outlet region. In some preferred embodiments, the at least two aerosol streams are separated during injection to prevent undesirable chemical interactions or precipitation of the active ingredients, additives, and / or excipients. The at least two pump units draw the first and second liquid compositions from the first and second reservoirs in discrete amounts, i.e., not continuously, and deliver them to the first and second outlet regions. The at least two pump units operate without propellants and generate pressure mechanically. At least two pump units or devices preferably each comprise a pump chamber and a means for storing potential energy, each device coupled to a pump chamber and lockable in a loaded position, and upon unlocking, the stored energy can be converted into movement of the pump chamber. The inhaler device comprises at least two potential energy storage units, for example, comprising a spring, a gas, or a magnetic force. Because each pump unit is coupled to a separate potential energy storage unit, each pump unit can be configured to eject each liquid composition with different forces or different volumes to compensate for any differences in the properties (e.g., viscosity) of the individual liquid compositions being dispensed.

[0039] In certain embodiments, the at least two, or more specifically, two potential energy storage units may each be in the form of a spring, and each of the at least two, or more specifically, two springs may have the same or different spring constants (k), preferably different spring constants, typically selected within the range of about 50 N / m (Newtons per meter) to about 5,000 (5000) N / m, for example, about 100 N / m to about 2,000 N / m, or about 150 N / m to about 1,500 N / m.

[0040] In more specific embodiments, the two springs may generate the same or different forces, typically ranging from about 5 N to about 200 N (Newtons), or from about 10 N to about 100 N, or from about 20 N to about 80 N, or from about 30 N to about 70 N, or from about 37 N to about 62 N. However, in even more specific embodiments, the two springs may generate different forces, with the first spring having a force selected within the range of about 80 N to about 120 N and the second spring having a force selected within the range of about 40 N to about 80 N.

[0041] The two potential energy storage units, particularly when in the form of springs such as spiral springs, can be made of a suitable elastic material such as a metal, e.g., steel, copper, beryllium-copper alloy, nickel alloy, particularly a nickel-chromium alloy such as Inconel®, or another material, e.g., a polymeric or ceramic material, e.g., zirconia or aluminum oxide, or rubber, e.g., a rubber spring. In certain embodiments, the two potential energy storage units may be made preferably from the same material, or may be made from two different materials.

[0042] In some embodiments, at least two outlet regions of the inhalation device eject the first and second liquid compositions, respectively, along their respective ejection trajectories. In some embodiments, the first and second outlet regions are incorporated into a single nozzle, or the first outlet region is incorporated into the first nozzle and the second outlet region is incorporated into the second nozzle. In some embodiments, the first outlet region comprises at least two channels for ejecting the first liquid composition from the device, and the second outlet region comprises at least two channels for ejecting the second liquid composition from the device. In some specific embodiments, the first liquid composition is ejected from at least two ejection channels, each having its own ejection trajectory, and the second liquid composition is ejected from at least two ejection channels, each having its own ejection trajectory and independent of the ejection channel of the first liquid composition, for a total of at least four outlet regions per inhaler device. In some particular embodiments, for each liquid composition, at least two ejection channels may be oriented at an angle such that at least two of the ejection trajectories intersect each other at the point of impact, such that collision-type (or collision-based) aerosol formation is achieved.

[0043] In some preferred embodiments, the exit region and / or nozzle are adapted to separately eject the first and second liquid compositions to avoid interference, undesirable chemical interaction, or precipitation of any potentially incompatible components (e.g., active ingredients, additives, and / or excipients) of the liquid compositions. In some embodiments, the first liquid composition is ejected from one ejection channel having its own ejection trajectory, i.e., the direction along which each ejected liquid stream leaves that channel, and the second liquid composition is ejected from another ejection channel having its own ejection trajectory. Alternatively, the first liquid composition is ejected from at least two ejection channels, each having its own ejection trajectory, and the second liquid composition is ejected from at least two ejection channels, each having its own ejection trajectory. In preferred embodiments, the exit region and / or nozzle are configured to prevent interference of the aerosol streams of the at least two liquid compositions upon ejection from the device.

[0044] In certain embodiments, the inhalation device according to the invention may relate to a mist inhaler, where the term "soft mist inhaler" (SMI) as used herein refers to a preferably non-powered mobile inhalation device for liquid formulations with slow atomization characteristics. In further particular embodiments, such an inhalation device, more particularly such a soft mist inhaler, comprises at least one impingement-type nozzle as described above for atomization / aerosolization of the administered medically active liquid.

[0045] Thus, in a further particular embodiment, the inhalation device according to the invention is a soft mist inhaler, and comprises at least two, more particularly two, impingement nozzles as described above, each having two outlet channels with two corresponding outlet trajectories, the two outlet trajectories of one impingement nozzle having one impingement point where the two outlet trajectories intersect. In a further particular embodiment, each of the at least two liquid compositions, more particularly the first and second liquid compositions, is dispensed or ejected by a separate impingement nozzle as described above.

[0046] Preferably, inhalation devices according to the present invention and embodiments described herein release a metered dose of each of the first and second liquid compositions upon actuation, with each metered dose having the same or different volume, typically at least about 1 μL (microliter). In further embodiments, the metered doses of the first and second liquid compositions released upon actuation of the inhalation device may each have the same or different volume, typically at least about 1 μL, 2 μL, 5 μL, 10 μL, or 15 μL, or at least about 20 μL, 25 μL, 30 μL, or 50 μL. In other embodiments, the metered doses of the first and second liquid compositions released upon actuation may each have the same or different volume, typically between about 1 μL and about 50 μL, or between about 5 and about 30 μL, or between about 10 and about 20 μL. In some embodiments, the metered doses of the first and second liquid compositions released upon actuation each have a volume of about 1 μL. In other embodiments, each of the metered doses of the first and second liquid compositions emitted upon actuation has a volume of about 10 μL. In yet other embodiments, each of the metered doses of the first and second liquid compositions emitted upon actuation has a volume of about 15 μL.

[0047] In another embodiment of the present invention, a single dose of the first and second liquid compositions may be released by one (single) actuation or by multiple actuations of the inhalation device.

[0048] Preferably, each single dose of the first and second liquid compositions contains at least about 0.1 μg (micrograms), e.g., about 0.1 μg to about 1,000 μg, or about 1 μg to about 250 μg, or about 1 μg to about 50 μg of the first active ingredient, and at least about 0.1 μg, e.g., about 0.1 μg to about 1,000 μg, or about 1 μg to about 250 μg, or about 1 μg to about 50 μg of the second active ingredient, which may have the same or different masses. In other embodiments, the first liquid composition contains the first active ingredient, and the second liquid composition contains at least 1 μg, 2 μg, 2.5 μg, 5 μg, 10 μg, 20 μg, 50 μg, or 100 μg of the second active ingredient, which may have the same or different masses. In still further embodiments, a single dose of the first liquid composition comprises an amount of a first active ingredient, and the second liquid composition comprises an amount of a second active ingredient, which may have the same or different masses in the range of about 1-10 μg, about 2-30 μg, or about 2.5-25 μg, and optionally a third active ingredient.

[0049] In further embodiments, the first and / or second liquid compositions may optionally comprise more than one active ingredient, for example a mixture of two or more different active ingredients in the amounts or concentrations described above.

[0050] In a further embodiment, the inhalation device can be comfortably held in one hand. The inhalation device comprises at least two reservoirs for separately storing first and second liquid compositions and at least two pump units, each including a pump chamber for generating pressure in the pump chamber. The first pump chamber is fluidly connected to the first reservoir, optionally by a first reservoir pipe (or reservoir pipe section), via a first check valve that blocks flow in the direction of the first reservoir. Similarly, the second pump chamber is fluidly connected to the second reservoir, optionally by a second reservoir pipe (or reservoir pipe section), via a second check valve that blocks flow in the direction of the second reservoir. Thus, the first and second check valves allow liquid to flow from the first and second reservoirs to the first and second pump chambers, while blocking flow in the opposite direction.

[0051] In some embodiments, the suction device further comprises a first riser pipe having an inner end facing at least one reservoir that can be accommodated in the first pump chamber and a first outlet region directly or indirectly fluid-tightly connected to the outer end of the first riser pipe, and a second riser pipe having an inner end facing at least one reservoir that can be accommodated in the second pump chamber and a second outlet region directly or indirectly fluid-tightly connected to the outer end of the second riser pipe.

[0052] In some embodiments, the internal volumes of the at least two pump chambers are changeable by relative movement of the pump chambers with respect to the riser pipes, with each riser pipe increasing its volume by being pushed into its respective pump chamber and decreasing its volume by being pulled out of its respective pump chamber. The term "internal volume" refers to the volume extending from the reservoir-facing inlet of each pump chamber to where the inner end of each riser pipe is located.

[0053] In another embodiment of the invention, each riser pipe is stationary and directly or indirectly and / or permanently or removably attached to the apparatus, and each pump chamber is movable relative to the apparatus. In other words, each riser pipe maintains its position relative to the apparatus, and each pump chamber can change its position relative to the apparatus by performing a piston-in-cylinder type movement of the stationary riser pipe of the movable pump chamber, particularly along its longitudinal axis. Such stationary riser pipes are described in detail in WO 2018 / 197730, which is incorporated herein by reference in its entirety.

[0054] In another embodiment, the immobility of each riser pipe is primarily related to the outlet area, rather than to the device. Thus, the outlet area and the riser pipe form a single unit from the viewpoint of mobility. However, if the outlet area itself is immobile relative to the device, this also applies to the riser pipe, thus achieving the described embodiment.

[0055] The advantage of these features is that the passage between the pump chamber and the reservoir can be designed with fewer constraints compared to known techniques. For example, it is possible to design significantly larger check valves, which are easier to manufacture because they do not need to be housed within hollow pistons known in the art. As a result, the size of each check valve is primarily limited only by the interior size of the device or, if such a structure is desired, the interior size of the potential energy storage unit surrounding the pumping unit. The (approximate) uniformity of the diameters of the valve, riser pipe, and reservoir pipe, as known in the art, becomes obsolete. Furthermore, because a movable piston does not need to be connected to each reservoir, the components entering the reservoir and the movable component (i.e., the pump chamber) can be designed independently of each other and better adapted to their individual functions. In this respect, the present invention offers greater design flexibility, since the at least two movable pump chambers, due to their robust structure and dimensions, offer a better opportunity to design a mechanically stable connection with the reservoir than would typically be possible with each movable riser pipe, which is typically less robust. Also, the connection between the pump chamber and the reservoir can be designed with a larger diameter to allow for higher flow rates and fluid viscosities. Furthermore, mechanical support for the reservoir can be incorporated into the component containing the pump chamber. Furthermore, the vent for reservoir pressure equalization can be moved away from the reservoir body itself, for example, to a connector that forms the interface between the reservoir and the pump chamber, easing construction and avoiding the need for an essentially "open" reservoir body.

[0056] According to one embodiment, each of the at least two check valves is adapted to open only when the pressure difference between the upstream and downstream sides of the valve, i.e., the reservoir and the pump chamber side, exceeds a predetermined threshold, and remains closed as long as the pressure difference is below the threshold. By "pressure difference," we mean that only the relative pressure difference between the two sides is relevant to determine whether the check valve will close or open, regardless of the specific pressure value.

[0057] Upon actuation of each of the at least two pump units, by building up a high pump chamber pressure, the pressure difference (high pressure in the pump chamber and significantly lower pressure in the reservoir resulting in a large pressure difference) becomes sufficiently high and exceeds a pressure difference threshold, resulting in each of the at least two check valves eventually opening and allowing the pressure chamber to be filled with liquid from the reservoir.

[0058] According to a further embodiment, the suction device comprises at least two outlet valves, one inside each of the at least two riser pipes, to avoid a return flow of liquid or air to the external end.

[0059] According to another embodiment, the suction device comprises at least two outlet valves between each of the at least two riser pipes and the at least two outlet areas for avoiding a return flow of liquid or air towards the outer ends of each of the at least two riser pipes.

[0060] Optionally, each of the at least two outlet valves may be of the type that prevents a pressure difference from falling below a threshold (and accepts a pressure difference from exceeding a threshold) as described above.

[0061] In some embodiments, to separate two outlet streams of the first and second liquid compositions, the first outlet region and the second outlet are integrated into a single nozzle, or the first outlet region is integrated into the first nozzle and the second outlet region is integrated into the second nozzle. In certain embodiments, the nozzle is configured as a stack of relatively flat plates. Such plates can preferably be manufactured by material subtraction techniques such as etching. Wafers of different materials, such as silicon, glass, metal, ceramic, or plastic, can form the semi-finished product. Channels leading to each outlet region are provided on one or even both of the two flat sides of the substrate. Several such plates can then be stacked to produce a nozzle stack providing multiple pairs of ejection channels. In some embodiments, each outlet region includes at least two channels for ejecting the liquid composition from the device.

[0062] In other embodiments, the nozzle is constructed from a three-dimensional rotationally symmetric base shape. Such base shapes can be cones, cylinders, or pyramids. Typically, the axis of rotation or symmetry of the base shape coincides with the major axis of the finished nozzle.

[0063] According to a further embodiment, each of the at least two reservoirs is rigidly attached to the pump chamber and is therefore movable within the device. This means that during each ejection cycle, the first reservoir moves together with the first pump chamber from an initial position where the first pump chamber has its maximum internal volume to an end position where it is minimum, and finally returns to the initial position. Similarly, the second reservoir moves together with the second pump chamber from an initial position where the second pump chamber has its maximum internal volume to an end position where it is minimum, and finally returns to the initial position. As used herein, the term "rigidly attached" includes both permanent and non-permanent (i.e., releasable) attachments. One advantage of this structure is that it provides the smallest possible dead volume between the reservoirs and the pump chamber.

[0064] According to another embodiment, each of the at least two reservoirs is connected to at least one pump chamber by a flexible element, such as a hose, and is rigidly attached to the device. Thus, according to this embodiment, each of the first and second reservoirs does not move with the first and second pump chambers but is rigidly (but typically detachably) attached to the device. One advantage of this structure is that the energy suddenly released upon unlocking the potential energy storage means acts only on the first and second pump chambers to accelerate them, but does not also act on the first and second reservoirs, which can typically have relatively large masses, especially at the beginning of their use. This results in higher accelerations of the first and second pump chambers and therefore higher pressures.

[0065] In another aspect, the present invention relates to a first reservoir containing a first liquid composition comprising one or more active ingredients, additives, and / or excipients, and a second reservoir containing a second liquid composition comprising one or more active ingredients, additives, and / or excipients, each of which is adapted for use in an inhalation device according to the first aspect of the present invention, or a combination of the above-described device embodiments. The first and second reservoirs may be adapted and standardized to be housed and integrated with other features and components of the inhalation device, in which case multiple reservoirs (e.g., two or more) may be housed and integrated in the inhalation device. The first reservoir is connectable to a first pump chamber, and the second reservoir is connectable to a second pump chamber. In one embodiment, each of the reservoirs (2A, 2B) according to the present invention is adapted to be securely attached to each of the pump chambers (3A, 3B) and thus movable within the device. In another embodiment, each of the reservoirs (2A, 2B) is adapted to connect to each of the pump chambers (3A, 3B) by means of a flexible element, rigidly attached to the device.

[0066] The amounts of the first and second liquid compositions that can be accommodated, i.e., stored in the first and second reservoirs, are amounts that will release at least one metered dose of the first and second liquid compositions upon actuation of the device. In some embodiments, the first and second reservoirs are multi-dose reservoirs, meaning that they contain multiple single doses that can be administered via multiple actuations of the device. Alternatively, the first and second reservoirs preferably contain an amount of the first and second liquid compositions that is compatible with multiple or multiple actuations of the inhalation device.

[0067] In one embodiment, the inhalation device and / or at least two reservoirs fitted to the inhalation device contain the at least two liquid compositions in an amount suitable for 1 to about 120 actuations of the inhalation device, or 1 to about 90 actuations, or 1 to about 60 actuations, or 1 to about 30 actuations, or 1 to about 20 actuations, or about 10 to about 90 actuations, or about 60 actuations of the inhalation device, or for 1 to 120 actuations, or 1 to 90 actuations, or 1 to 60 actuations, or 1 to 30 actuations, or 1 to 20 actuations, or about 10 to about 60 actuations, or about 80 actuations of the aerosolized liquid compositions.

[0068] In a further aspect of the invention, an inhaler device comprises a first liquid composition in a first reservoir and a second liquid composition in a second reservoir, wherein the first and second liquid compositions are formulated as compositions suitable and adapted for use in inhalation, i.e., compositions that may be atomized for inhalation and are physiologically acceptable for inhalation by a subject.

[0069] The first and second liquid compositions contained in the inhalation device, more particularly in the first and second reservoirs, may be in the form of a dispersion, e.g., a suspension having a liquid continuous phase and a solid dispersed phase. Preferably, however, the first and second liquid compositions are in the form of a solution, in which the active ingredient and other materials are dissolved and solubilized in a liquid carrier solution.

[0070] In some embodiments, the first and second liquid compositions contain the same or different solvent compositions as the liquid carrier. However, in certain embodiments, it is preferred that the first and second liquid compositions contain different solvent compositions as the liquid carrier. For example, both the first and second liquid compositions may contain aqueous solutions. In other embodiments, the first liquid composition may contain an aqueous solution, and the second liquid composition may contain an organic solution or a mixture of an aqueous solution and an organic solution. In some embodiments, the organic solution comprises an alcohol solution, such as an ethanol solution.

[0071] In further specific embodiments, the liquid carrier or solvent comprises water and / or ethanol, preferably ethanol. In further specific embodiments, such liquid carrier or solvent comprises, or preferably consists of, ethanol or a mixture of ethanol and water, wherein the ethanol may comprise at least about 50 wt%, or at least about 60 wt%, or at least about 70 wt%, or even more, and a corresponding amount of water of about 50 wt% or less, or about 40 wt% or less, or about 30 wt% or less, or even less. In certain embodiments, the liquid vehicle or solvent comprises or consists of ethanol in an amount of about 60 to about 80 wt%, e.g., about 70 wt%, and water in an amount of about 40 to about 20 wt%, e.g., about 30 wt%.

[0072] In some embodiments, the first liquid composition preferably contains a pharmaceutically effective amount of a long-acting beta agonist (LABA). Non-limiting exemplary long-acting beta agonists include albuterol, arformoterol, bambuterol, bitolterol, broxaterol, carbuterol, clenbuterol, fenoterol, formoterol, hexoprenaline, ibuterol, indacaterol, indacterol, isoetharine, isoprenaline, levosalbutamol, mabuterol, mercapdrin, metaproterenol, orciprenaline, pirbuterol, procaterol, reproterol, rimiterol, ritodrine, salmeterol, salmefamol, soterenoto, sulfonterol, tialamde, terbutaline, and terbuterol. In some embodiments, the long-acting beta agonist is olodaterol.

[0073] In other embodiments, the first liquid composition preferably comprises a pharmaceutically effective amount of a long-acting muscarinic antagonist (LAMA).Non-limiting exemplary long-acting muscarinic antagonists include aclidinium bromide, glycopyrronium bromide, levrefenacin, tiotropium, such as tiotropium bromide, umeclidinium bromide, oxitropium bromide, flutropium bromide, ipratropium bromide, trospium chloride and tolterodine.In some embodiments, the long-acting muscarinic antagonist is tiotropium bromide.

[0074] In some embodiments, the first liquid composition comprises a mixture of a long-acting beta agonist and a long-acting muscarinic antagonist, hi some embodiments, the mixture of a long-acting beta agonist and a long-acting muscarinic antagonist comprises olodaterol and tiotropium bromide.

[0075] In some embodiments, the second liquid composition comprises an inhaled corticosteroid (ICS). Non-limiting exemplary inhaled corticosteroids include prednisolone, prednisone, butixocort propionate, flunisolide, beclomethasone, triamcinolone, budesonide, fluticasone, mometasone (furoate), ciclesonide, rofleponide, dexamethasone, etiprenol-dichloroacetate, deflazacort, etiprednol, loteprednol, RPR-106541, NS-126, and ST-26. In some embodiments, the inhaled corticosteroid is ciclesonide.

[0076] In some embodiments, the first liquid composition comprises a long-acting beta-agonist and the second liquid composition comprises an inhaled corticosteroid. In certain embodiments, the long-acting beta-agonist is olodaterol and the inhaled corticosteroid is ciclesonide.

[0077] In some embodiments, the first liquid composition comprises a mixture of a long-acting beta agonist and a long-acting muscarinic antagonist, and the second liquid composition comprises an inhaled corticosteroid. In certain embodiments, the mixture of a long-acting beta agonist and a long-acting muscarinic antagonist comprises olodaterol and tiotropium bromide, and the inhaled corticosteroid is ciclesonide.

[0078] In further embodiments, the first and second liquid compositions may optionally contain one or more physiologically acceptable additives and / or excipients suitable for inhalation use. Excipients that may be featured in the compositions include, but are not limited to, one or more buffers for adjusting or controlling the pH of the solution, salts, flavoring agents, surfactants, lipids, antioxidants, preservatives, such as benzalkonium chloride (BAC), parabens, such as methylparaben, ethylparaben, propylparaben, sodium benzoate, sorbic acid and its salts, and cosolvents, which may be used to enhance or improve solubility, such as ethanol or glycol. In some embodiments, the liquid compositions are essentially free of propellants, such as hydrofluoroalkane (HFA) propellants.

[0079] A further aspect of the present invention relates to the use of an inhalation device in the treatment and prophylactic treatment of a disease or condition. In certain embodiments, the disease or condition is a pulmonary or respiratory disease or condition. In particular, the inhalation device according to the present invention is used to treat or prevent a pulmonary disease or condition. As understood herein, a pulmonary disease or condition can affect one or more anatomical aspects and / or function of a subject's lungs and associated airways.

[0080] Treatment refers to the administration of the first and second liquid compositions for the treatment of a disease or condition, for example, resulting in the improvement, reduction or alleviation of at least one symptom of the disease or condition, or the halting or delay of the progression of at least one symptom of the disease or condition, for example, the maintenance of lung function. Prevention of a disease or condition can be understood as prophylactic treatment, and refers to the administration of the first and second liquid compositions to a subject who may not have developed the disease or condition but is at risk or susceptible to the disease or condition.

[0081] For both the treatment or prevention of a disease or condition, the first and second liquid compositions are administered via the inhalation device and embodiments described herein in therapeutically effective amounts, such as those amounts described above.

[0082] In particularly preferred embodiments, the disease or condition is a pulmonary disease, such as asthma or chronic obstructive pulmonary disease ("COPD").

[0083] In a further aspect, the present invention provides, and is also provided in the context of, the use of an inhalation device or reservoir containing the first and second liquid compositions described in any one of the above embodiments in the manufacture or preparation of a pharmaceutical or medical device for treating a subject in need thereof in connection with any disease or condition. In certain embodiments, the disease or condition is a pulmonary disease or condition, such as asthma or chronic obstructive pulmonary disease (COPD). In other specific embodiments, the first liquid composition comprises a long-acting beta-agonist, such as olodaterol, and the second liquid composition comprises an inhaled corticosteroid, such as ciclesonide. In yet other specific embodiments, the first liquid composition further comprises a long-acting muscarinic antagonist, such as tiotropium bromide.

[0084] In yet a further aspect, the present invention also relates to a method for treating or preventing a disease or condition in a subject in need thereof, comprising administering metered doses of a first liquid composition and a second liquid composition using an inhalation device described in any one or combination of the above embodiments. In certain embodiments, the disease or condition is a pulmonary disease or condition, such as asthma or chronic obstructive pulmonary disease (COPD). In other specific embodiments, the first liquid composition comprises a long-acting beta-agonist, such as olodaterol, and the second liquid composition comprises an inhaled corticosteroid, such as ciclesonide. In yet other specific embodiments, the first liquid composition further comprises a long-acting muscarinic antagonist, such as tiotropium bromide.

[0085] Preferably, the inhalation device used in the methods described herein is a handheld, i.e., portable, device, whereby administration of the first and second liquid compositions and actuation of the device are carried out directly by the human subject or patient themselves, according to predetermined instructions that may accompany the device.

[0086] In a further aspect, the present invention provides a method for delivering a liquid composition to a subject in need thereof, the method comprising providing the subject with an inhalation device as described above. The subject is preferably a human patient, particularly a human patient suffering from a disease or condition, preferably a pulmonary disease such as asthma or COPD. The patient may further be provided with instructions for using the device, activating the device, and inhaling the aerosol emitted from the device.

[0087] In yet a further aspect, the present invention provides a method of treating a subject suffering from a disease or condition, preferably a pulmonary disease such as asthma or COPD, comprising administering to the subject first and second liquid compositions using the device described above. Again, the patient can be provided with instructions for using the device, activating the device, and inhaling the aerosol emitted from the device.

[0088] In a still further aspect, the present invention provides a combination of a first and a second liquid composition for use in a method of treating a subject suffering from a disease or condition, preferably a pulmonary disease such as asthma or COPD, wherein the first and second liquid compositions are administered to the subject using an inhalation device according to the first aspect of the invention. [Brief explanation of the drawings]

[0089] [Figure 1] 1 shows the main components of an inhalation device useful in practicing the present invention.

[0090] The major components of an exemplary inhalation device useful in practicing the present invention are shown generally, not to scale, in Figure 1, prior to first use. The device shown represents a non-limiting embodiment of the inhalation device of the present invention disclosed herein.

[0091] The inhalation device comprises a housing 1, preferably shaped and sized so that it can be held in one hand and operated with one finger, e.g., the thumb (not shown). The device further comprises two reservoirs 2A, 2B for storing medically active liquids F1, F2, respectively. The illustrated reservoirs 2A, 2B are designed to be collapsible. This means that during the emptying process, the elastic or at least calcareous walls buckle, resulting in no or very little increase in the relative negative pressure (i.e., partial vacuum) required to extract a given amount of liquid F1, F2. A similar effect can be achieved by an alternative embodiment (not shown) in which a rigid container has a movable bottom, thereby allowing the internal volume of each reservoir to be continuously reduced.

[0092] The inhalation device further comprises a pump unit having two pump chambers 3A, 3B for generating the desired pressure required to expel and nebulize the liquids F1, F2. The pump unit may also include additional components (push buttons, locking devices, etc.) not shown.

[0093] At least two potential energy storage units 6A, 6B (eg springs) are provided, each coupled to one end (facing upward) of a pump chamber 3A, 3B and supported by the housing 1 (bottom in the figure).

[0094] The suction device further comprises at least two riser pipes 4A, 4B having inner ends 4A', 4B' facing at least one respective reservoir that can be accommodated in said pump chambers 3A, 3B. In other words, the riser pipes 4A, 4B can be at least partially pushed into the pump chambers 3A, 3B, resulting in a reduction in the internal volume of the pump chambers 3A, 3B. The term "internal volume" refers to the volume extending from the reservoir-facing inlets of the pump chambers 3A, 3B to the locations where the inner ends 4A', 4B' of the riser pipes 4A, 4B are located.

[0095] Preferably, in the portion serving to receive the riser pipe, the pumping chambers 3A, 3B have a portion with a circular inner cross section corresponding to the (hence) circular outer cross section of the corresponding riser pipe portion, although of course other cross-sectional shapes are possible.

[0096] The suction device further comprises two outlet areas 5A, 5B, each fluid-tightly connected to the outer ends 4A″, 4B″ of the riser pipes 4A, 4B. The outlet areas 5A, 5B are suitable for spraying / atomizing liquid in a single stream or at least two streams using the principle of two colliding liquid jets. The outlet areas 5A, 5B shown by way of example include two separate nozzle units, but the outlet areas 5A, 5B may also be included in one nozzle unit (not shown). Each of the two outlet areas 5A, 5B is connected to a respective pump chamber 3A, 3B and thus to a liquid reservoir 2A, 2B. Each liquid F1, F2 has its own pump chamber 3A, 3B to avoid undesired mixing.

[0097] The riser pipes 4A, 4B are designed to be immobile and rigidly attached to the device. The riser pipes 4A, 4B are also rigidly attached to the outlet areas 5A, 5B, which in turn are similarly attached to the device. Conversely, the pump chambers 3A, 3B are designed to be movable relative to the device and the outlet areas 5A, 5B. The advantages of this design have already been explained; see the respective sections above. List of Items In particular, the present invention relates to the following specific embodiments:

[0098] 1. An inhalation device for generating an aerosol of at least two liquid compositions, comprising at least first and second reservoirs (2A, 2B) containing at least first and second liquid compositions (F1, F2), wherein the inhalation device is a pump-actuated inhaler adapted to, upon actuation, release a metered dose of the first liquid composition (F1) from the first reservoir (2A) and a metered dose of the second liquid composition (F2) from the second reservoir (2B), the inhalation device comprising first and second reservoirs (2A, 2B) for containing the first and second liquid compositions (F1, F2) fluidly connected to at least first and second pump chambers (3A, 3B) for generating a first pressure in a first pump chamber (3A) and a second pressure in a second pump chamber (3B), each of which and a second potential energy storage unit (6A) coupled to one end of the first pump chamber (3A), and a second potential energy storage unit (6B) coupled to one end of the second pump chamber (3B).

[0099] 2. An inhalation device as described in embodiment 1, wherein first and second pump chambers (3A, 3B) coupled to separate potential energy storage units (6A, 6B) generate the desired pressure for expelling at least two liquid compositions.

[0100] 3. An inhalation device according to any one of embodiments 1 to 2, wherein each of the first and second riser pipes (4A, 4B) is stationary and fixedly attached to the device and / or the first and second outlet areas (5A, 5B), and each of the first and second pump chambers (3A, 3B) is movable relative to the device and / or the first and second outlet areas (5A, 5B).

[0101] 4. An inhalation device according to any one of embodiments 1 to 3, wherein the first potential energy storage unit (6A) and the second potential energy storage unit (6B) each generate the same force.

[0102] 5. An inhalation device according to any one of embodiments 1 to 3, wherein the first potential energy storage unit (6A) and the second potential energy storage unit (6B) generate different forces.

[0103] 6. An inhalation device according to embodiment 4 or 5, wherein the force is from about 5 Newtons (N) to about 200 Newtons (N).

[0104] 7. An inhalation device according to any one of embodiments 1 to 6, wherein the first potential energy storage unit (6A) and the second potential energy storage unit (6B) each comprise a spring.

[0105] 8. The inhalation device of claim 7, wherein each spring has the same or a different spring constant (k) of about 50 neurons per meter (N / m) to about 5,000 neurons per meter (N / m).

[0106] 9. An inhalation device according to any one of embodiments 1 to 8, wherein the first outlet area (5A) and the second outlet area (5B) are combined into a single nozzle.

[0107] 10. An inhalation device according to any one of embodiments 1 to 8, wherein the first outlet area (5A) is incorporated into a first nozzle and the second outlet area (5B) is incorporated into a second nozzle.

[0108] 11. An inhalation device according to any one of embodiments 1 to 10, wherein the first outlet area (5A) comprises at least two channels for expelling the first liquid composition (F1) from the device, and the second outlet area (5B) comprises at least two channels for expelling the second liquid composition (F2) from the device.

[0109] 12. An inhalation device according to any one of embodiments 1 to 11, wherein the first reservoir and the second reservoir are incorporated into a single cartridge unit, or the first reservoir is incorporated into the first cartridge unit and the second reservoir is incorporated into the second cartridge unit.

[0110] 13. An inhalation device according to any one of embodiments 1 to 12, wherein the metered dose of the first liquid composition (F1) has the same volume as the metered dose of the second liquid composition (F2).

[0111] 14. An inhalation device according to any one of embodiments 1 to 12, wherein the metered dose of the first liquid composition (F1) has a different volume than the metered dose of the second liquid composition (F2).

[0112] 15. An inhalation device according to any one of embodiments 1 to 14, wherein the first liquid composition (F1) and the second liquid composition (F2) comprise the same or different solvent compositions.

[0113] 16. An inhalation device according to embodiment 15, wherein the first liquid composition (F1) comprises an aqueous solution and the second liquid composition (F2) comprises an organic solution or a mixture of an aqueous solution and an organic solution.

[0114] 17. An inhalation device according to embodiment 16, wherein the organic solution comprises an alcohol solution.

[0115] 18. An inhalation device according to any one of embodiments 1-17, wherein the first liquid composition comprises a long-acting beta-agonist and the second liquid composition comprises an inhaled corticosteroid.

[0116] 19. An inhalation device according to embodiment 18, wherein the metered dose of the first liquid composition comprising the long-acting beta-agonist has a volume of at least 1 μL, and the metered dose of the second liquid composition comprising the inhaled corticosteroid has a volume of at least 1 μL.

[0117] 20. An inhalation device according to embodiment 19, wherein the metered dose of the first liquid composition comprises the long-acting beta-agonist in an amount of at least 1 μg, and the metered dose of the second liquid composition comprises the inhaled corticosteroid in an amount of at least 1 μg.

[0118] 21. An inhalation device according to any one of embodiments 18-20, wherein the first liquid composition comprises a mixture of a long-acting beta-agonist and a long-acting muscarinic antagonist, and the second liquid composition comprises an inhaled corticosteroid.

[0119] 22. An inhalation device according to embodiment 21, wherein the metered dose of the first liquid composition comprising the long-acting beta-agonist and the long-acting muscarinic antagonist has a volume of at least 1 μL, and the metered dose of the second liquid composition comprising the inhaled corticosteroid has a volume of at least 1 μL.

[0120] 23. An inhalation device according to embodiment 22, wherein the metered dose of the first liquid composition comprises the long-acting beta-agonist in an amount of at least 1 μg, and the long-acting muscarinic antagonist in an amount of at least 1 μg, and the metered dose of the second liquid composition comprises the inhaled corticosteroid in an amount of at least 1 μg.

[0121] 24. The inhalation device of any one of embodiments 18-23, wherein the long-acting beta-agonist is selected from the group consisting of albuterol, arformoterol, bambuterol, bitolterol, broxaterol, carbuterol, clenbuterol, fenoterol, formoterol, hexoprenaline, ibuterol, indacaterol, indacterol, isoetharine, isoprenaline, levosalbutamol, mabuterol, mercapadrine, metaproterenol, orciprenaline, pirbuterol, procaterol, reproterol, rimiterol, ritodrine, salmeterol, salmefamol, soterenoto, sulfonterol, tialamide, terbutaline, and terbuterol.

[0122] 25. An inhalation device according to any one of embodiments 18 to 24, wherein the long-acting beta agonist is olodeterol.

[0123] 26. An inhalation device according to any one of embodiments 21-25, wherein the long-acting muscarinic antagonist is selected from the group consisting of aclidinium bromide, glycopyrronium bromide, levufenacin, tiotropium bromide, umeclidinium bromide, oxitropium bromide, flutropium bromide, ipratropium bromide, trospium chloride, and tolterodine.

[0124] 27. An inhalation device according to any one of embodiments 21-26, wherein the long-acting muscarinic antagonist is tiotropium bromide.

[0125] 28. An inhalation device according to any one of embodiments 18 to 27, wherein the inhaled corticosteroid is selected from the group consisting of prednisolone, prednisone, butixocol propionate, flunisolide, beclomethasone, triamcinolone, budesonide, fluticasone, mometasone, ciclesonide, rofleponide, dexamethasone, ethiprodol-dichloroacetate, deflazacort, etiprednol, loteprednol, RPR-106541, NS-126 and ST-26.

[0126] 29. An inhalation device according to any one of embodiments 18-28, wherein the inhaled corticosteroid is ciclesonide.

[0127] 30. An inhalation device according to any one of embodiments 21-29, wherein the long-acting muscarinic antagonist is tiotropium bromide, the long-acting beta-agonist is olodaterol, and the inhaled corticosteroid is ciclesonide.

[0128] 31. An inhalation device according to any one of embodiments 1 to 30, wherein the first reservoir (2A) is rigidly attached to the first pump chamber (3A) and the second reservoir (2B) is rigidly attached to the second pump chamber (3B) and is therefore movable within the device, or the first reservoir (2A) is connected to the first pump chamber (3A) using a first flexible element and the second reservoir (2B) is connected to the second pump chamber (3B) using a second flexible element, and the first and second reservoirs (2A, 2B) are each rigidly attached to the device.

[0129] 32. An inhalation device according to any one of embodiments 1 to 31, wherein each of the first and second liquid compositions further comprises one or more excipients, buffers, and / or co-solvents.

[0130] 33. An inhalation device according to any one of embodiments 1 to 32 for use in the treatment or prevention of a disease or condition.

[0131] 34. An inhalation device according to any one of embodiments 1 to 33 for use in the treatment or prevention of a pulmonary disease or condition.

[0132] 35. An inhalation device according to embodiment 34, wherein the pulmonary disease or condition is asthma or chronic obstructive pulmonary disease ("COPD").

[0133] 36. An inhalation device according to any one of embodiments 18-35, wherein the long-acting beta-agonist is dissolved in a first liquid composition and the inhaled corticosteroid is dissolved in a second liquid composition.

[0134] 37. The inhalation device of embodiment 36, wherein the first liquid composition further comprises a long-acting muscarinic antagonist dissolved in the first liquid composition.

[0135] 38. A method of treating a subject suffering from a disease or condition, comprising administering to the subject effective amounts of at least two active ingredients using a device described in any one of embodiments 1 to 37.

[0136] 39. The method of embodiment 38, wherein the disease or condition is a pulmonary disease or condition.

[0137] 40. The method of any one of embodiments 38-39, wherein the at least two active ingredients comprise a long-acting beta-agonist and an inhaled corticosteroid.

[0138] 41. The method of embodiment 40, wherein the at least two active ingredients comprise a long-acting beta-agonist, a long-acting muscarinic antagonist, and an inhaled corticosteroid.

[0139] 42. The method of any one of embodiments 39-41, wherein the pulmonary disease or condition is asthma or chronic obstructive pulmonary disease ("COPD").

[0140] 43. A method for treating a subject suffering from a disease or condition, comprising administering to the subject effective amounts of at least two liquid compositions, each comprising an active ingredient, using a device described in any one of embodiments 1 to 37.

[0141] 44. A method for delivering at least two liquid compositions to a subject in need thereof, comprising providing the subject with an inhalation device described in any one of embodiments 1 to 37.

[0142] 45. The method of any one of embodiments 43-44, wherein the at least two liquid compositions comprise a long-acting beta-agonist and an inhaled corticosteroid.

[0143] 46. The method of embodiment 45, wherein the at least two liquid compositions comprise a first liquid composition comprising a long-acting beta-agonist and a long-acting muscarinic antagonist, and a second liquid composition comprising an inhaled corticosteroid.

[0144] 47. A first reservoir containing a first liquid composition comprising a long-acting beta-agonist, and a second reservoir containing a second liquid composition comprising an inhaled corticosteroid, wherein the first and second reservoirs are adapted for use with an inhalation device according to any one of embodiments 1 to 37.

[0145] 48. The reservoir of embodiment 47, wherein the first liquid composition further comprises a long-acting muscarinic antagonist. [Explanation of symbols]

[0146] 1. Housing 2A, 2B First and second reservoirs 3A, 3B First and second pump chambers 4A, 4B First and second riser pipes 4A', 4B' Internal end 4A'', 4B'' External end 5A, 5B First and second outlet regions 6A, 6B Potential Energy Storage Unit F1, F2 First and second liquid compositions

Claims

1. An inhalation device for generating an aerosol of at least two liquid compositions, comprising at least first and second reservoirs (2A, 2B) containing at least first and second liquid compositions (F1, F2), said inhalation device being a pump-actuated inhaler adapted to, upon actuation, release a metered dose of said first liquid composition (F1) from said first reservoir (2A) and a metered dose of said second liquid composition (F2) from said second reservoir (2B), said first and second liquid compositions being aerosols of at least two liquid compositions, the first and second reservoirs (2A, 2B) for containing the first and second liquid compositions (F1, F2) are fluidly connected to at least first and second pump chambers (3A, 3B) for generating a first pressure in the first pump chamber (3A) and a second pressure in the second pump chamber (3B), and first and second riser pipes (4A, 4B) each of which is receivable at inner ends (4A', 4B') facing the reservoirs of the first and second pump chambers (3A, 3B); wherein the internal volumes of the first and second pump chambers (3A, 3B) are changeable by relative movement of the first and second pump chambers (3A, 3B) with respect to the first and second riser pipes (4A, 4B); at least first and second outlet areas (5A, 5B) adapted to discharge the first and second liquid compositions (F1, F2) from the suction device, respectively; and a first potential energy store coupled to one end of the first pump chamber (3A). a second potential energy storage unit (6B) coupled to one end of the second pump chamber (3B), wherein each of the first and second riser pipes (4A, 4B) is stationary and rigidly attached to the device and / or the first and second outlet areas (5A, 5B), and each of the first and second pump chambers (3A, 3B) is movable relative to the device and / or the first and second outlet areas (5A, 5B); 1. An inhalation device, wherein the first potential energy storage unit (6A) and the second potential energy storage unit (6B) generate different forces, and the first and second liquid compositions (F1, F2) comprise different solvent compositions as liquid carriers.

2. 2. The inhalation device of claim 1, wherein the first and second pump chambers (3A, 3B) coupled to separate potential energy storage units (6A, 6B) generate the desired pressures for expelling the at least two liquid compositions.

3. 3. The inhalation device of claim 1 or 2, wherein the force is from about 5 Newtons (N) to about 200 Newtons (N).

4. Inhalation device according to any one of claims 1 to 3, wherein the first potential energy storage unit (6A) and the second potential energy storage unit (6B) each comprise a spring.

5. 5. The inhalation device of claim 4, wherein each spring has the same or a different spring constant (k) of about 50 N / m to about 5,000 (5000) N / m.

6. An inhalation device according to any one of claims 1 to 5, wherein the metered dose of the first liquid composition (F1) has the same volume as the metered dose of the second liquid composition (F2).

7. 6. An inhalation device according to any one of claims 1 to 5, wherein the metered dose of the first liquid composition (F1) has a different volume than the metered dose of the second liquid composition (F2).

8. 8. An inhalation device according to any one of claims 1 to 7, wherein the first liquid composition comprises a long-acting beta agonist and the second liquid composition comprises an inhaled corticosteroid.

9. 9. The inhalation device of claim 8, wherein the first liquid composition comprises a mixture of a long-acting beta agonist and a long-acting muscarinic antagonist, and the second liquid composition comprises an inhaled corticosteroid.

10. 10. The inhalation device of claim 8 or 9, wherein the long-acting beta-agonist is selected from the group consisting of albuterol, arformoterol, bambuterol, bitolterol, broxaterol, carbuterol, clenbuterol, fenoterol, formoterol, hexoprenaline, ibuterol, indacaterol, indacterol, isoetharine, isoprenaline, levosalbutamol, mabuterol, mercapadrine, metaproterenol, orciprenaline, pirbuterol, procaterol, reproterol, rimiterol, ritodrine, salmeterol, salmefamol, soterenoto, sulfonterol, tialamide, terbutaline, and terbuterol.

11. An inhalation device according to any one of claims 8 to 10, wherein the long-acting beta agonist is orodeterol.

12. 12. An inhalation device according to claim 9 or 11, wherein the long-acting muscarinic antagonist is selected from the group consisting of aclidinium bromide, glycopyrronium bromide, levufenacin, tiotropium bromide, umeclidinium bromide, oxitropium bromide, flutropium bromide, ipratropium bromide, trospium chloride, and tolterodine.

13. 13. An inhalation device according to any one of claims 9 to 12, wherein the long-acting muscarinic antagonist is tiotropium bromide.

14. 14. An inhalation device according to any one of claims 8 to 13, wherein the inhaled corticosteroid is selected from the group consisting of prednisolone, prednisone, butixocol propionate, flunisolide, beclomethasone, triamcinolone, budesonide, fluticasone, mometasone, ciclesonide, rofleponide, dexamethasone, etiprednol dichloroacetate, deflazacort, etiprednol, loteprednol, RPR-106541, NS-126 and ST-26.

15. 15. An inhalation device according to any one of claims 8 to 14, wherein the inhaled corticosteroid is ciclesonide.

16. 16. An inhalation device according to any one of claims 9 to 15, wherein the long-acting muscarinic antagonist is tiotropium bromide, the long-acting beta agonist is olodaterol, and the inhaled corticosteroid is ciclesonide.

17. 17. An inhalation device according to any one of claims 1 to 16, wherein the first liquid composition (F1) comprises an aqueous solution and the second liquid composition (F2) comprises an organic solution or a mixture of an aqueous solution and an organic solution.

18. 18. The inhalation device of claim 17, wherein the organic solution comprises an alcohol solution.

19. Inhalation device according to any one of the preceding claims, wherein the first outlet area (5A) and the second outlet area (5B) are combined into a single nozzle.

20. Inhalation device according to any one of the preceding claims, wherein the first outlet area (5A) is incorporated into a first nozzle and the second outlet area (5B) is incorporated into a second nozzle.

21. 21. An inhalation device according to any one of claims 1 to 20, wherein the first outlet area (5A) comprises at least two channels for the ejection of the first liquid composition (F1) from the device and the second outlet area (5B) comprises at least two channels for the ejection of the second liquid composition (F2) from the device.

22. An inhalation device according to any preceding claim, wherein the first reservoir and the second reservoir are incorporated into a single cartridge unit.

23. An inhalation device according to any preceding claim, wherein the first reservoir is incorporated in a first cartridge unit and the second reservoir is incorporated in a second cartridge unit.

24. An inhalation device according to any one of claims 1 to 23, wherein the inhalation device is a soft mist inhaler.

25. 25. The inhalation device of claim 24, wherein the soft mist inhaler comprises at least two impingement nozzles, each having two outlet channels with two corresponding outlet trajectories, the two outlet trajectories of one impingement nozzle having one impingement point where the two outlet trajectories intersect.

26. An inhalation device according to any one of claims 1 to 25 for use in the treatment or prevention of a disease or condition.

27. An inhalation device according to any one of claims 1 to 26 for use in the treatment or prevention of a lung disease or condition.

28. 28. An inhalation device for use according to claim 27, wherein the pulmonary disease or condition is asthma or chronic obstructive pulmonary disease ("COPD").

29. 29. A first reservoir containing a first liquid composition comprising a long-acting beta-agonist, and a second reservoir containing a second liquid composition comprising an inhaled corticosteroid, said first and second reservoirs adapted for use with an inhalation device according to any one of claims 1 to 28.

30. 30. The reservoir of claim 29, wherein the first liquid composition further comprises a long-acting muscarinic antagonist.

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