Endobronchial valve treatment appears to improve lung function in patients with severe emphysema

September 08, 2017

Sept. 8, 2017--People with severe emphysema may breathe better after a minimally invasive procedure that places valves in the airways leading to diseased portions of their lungs, according to a randomized, controlled trial published online in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

In "A Multicenter RCT of Zephyr® Endobronchial Valve Treatment in Heterogeneous Emphysema (TRANSFORM)," European researchers report results from the first multicenter randomized, controlled trial comparing the therapeutic approach developed by Pulmonx Corp. to standard of care. The one-way Zephyr® valve keeps air from entering diseased regions of the lung, allowing healthier regions to expand and function better.

The authors note that previous studies of the valves, which are placed using a bronchoscope, found that for patients with severe emphysema, this minimally invasive therapy represents an alternative to lung volume reduction surgery. Patients undergoing endobronchial valve (EBV) therapy appear to experience similar improvements in lung function, shortness of breath, exercise intolerance and quality of life--without the morbidity and mortality previously associated with surgery.

"EBVs have been shown to work in single center trials, but these studies tend to be performed at centers, and by physicians, with considerable experience, so the results may not be generalizable to other centers," said lead study author Samuel V. Kemp, MD, a respiratory physician and expert in interventional bronchoscopy at Royal Brompton Hospital, in the U.K. "What is interesting about this multicenter trial is that the results are at least as good as the single center studies, even though some of the investigators were new to the technique."

Zephyr® valves have been certified for human use in Europe, but are not widely available to patients in all health care systems. The valves have not been approved in the U.S., though a clinical trial of the technology is underway to support an application to the Food and Drug Administration for approval.

The European study enrolled 97 patients from 17 medical centers. The patients were all ex-smokers over the age of 40 who had severe heterogeneous emphysema (emphysema isolated to certain parts of the lung). Sixty-five were randomly assigned to the EBV arm. On average, they received four valves to cut off diseased portions of their lungs that did not receive collateral ventilation (ventilation of alveoli through passages that bypass the normal airways). The other patients received standard of care based on each medical center's protocols for caring for patients following bronchoscopy.

The researchers found: After six months, 30 of the 32 participants in the control arm left the study and received EBV therapy. The authors will continue to follow those who received EBVs for up to two years.

"There has been a lot of skepticism about valves, largely owing to poorly designed early trials," Dr. Kemp said. "TRANSFORM proves that EBVs are a safe and effective treatment for appropriately selected patients with severe emphysema.

"For these patients, the benefits of EBVs are far greater than standard medical therapy, so it is important that patients be assessed by a multidisciplinary team to determine if this treatment will help them breathe better."

Dr. Kemp added that for those patients with collateral ventilation, valves are not suitable and patients should be considered for lung volume reduction surgery.
Follow Us

ATS - @atscommunity
AJRCCM - @ATSBlueEditor

About the American Journal of Respiratory and Critical Care Medicine (AJRCCM):

The AJRCCM is a peer-reviewed journal published by the American Thoracic Society. The Journal takes pride in publishing the most innovative science and the highest quality reviews, practice guidelines and statements in pulmonary, critical care and sleep medicine. With an impact factor of 12.996, it is the highest ranked journal in pulmonology. Editor: Jadwiga Wedzicha, MD, professor of respiratory medicine at the National Heart and Lung Institute (Royal Brompton Campus), Imperial College London, UK.

About the American Thoracic Society:

Founded in 1905, the American Thoracic Society is the world's leading medical association dedicated to advancing pulmonary, critical care and sleep medicine. The Society's 15,000 members prevent and fight respiratory disease around the globe through research, education, patient care and advocacy. The ATS publishes three journals, the American Journal of Respiratory and Critical Care Medicine, the American Journal of Respiratory Cell and Molecular Biology and the Annals of the American Thoracic Society.

The ATS will hold its 2018 International Conference, May 18-23, in San Diego, California, where world-renowned experts will share the latest scientific research and clinical advances in pulmonary, critical care and sleep medicine.

American Thoracic Society

Related Lung Function Articles from Brightsurf:

Exercised over nothing: Masks don't impair lung function during physical activity
A team of American and Canadian researchers report that while they may feel uncomfortable, there is little empirical evidence that wearing a facemask significantly diminishes lung function, even when worn during heavy exercise.

Lung, immune function in kids could protect from severe COVID-19
Differences in lung physiology and immune function in children could be why they are more often spared from severe illness associated with COVID-19 than adults.

Identification of new factors important in maintaining lung function in the elderly
Japanese researchers have found that elderly carriers of a specific DsbA-L gene type are at increased risk for lung function decline.

Weight gain associated with accelerated lung function decline in adulthood
Lung function declines naturally over the course of the human lifespan.

Inhaled immunosuppressant may increase survival, pulmonary function after lung transplant
University of Maryland School of Medicine researchers found that lung transplant recipients who had early signs of organ rejection could increase their chances of survival by inhaling a liposomal form of the immunosuppression drug cyclosporine through an investigational nebulizer.

Exposure to BPA in the womb linked to wheezing and poorer lung function in children
Pregnant women exposed to higher levels of the commonly used chemical bisphenol A (BPA) are more likely to have children who suffer with wheezing and poorer lung function, according to research presented at the European Respiratory Society International Congress.

Exposure to outdoor air pollutants, change in emphysema, lung function
Whether exposure to outdoor air pollutants is associated with emphysema progression and change in lung function was the focus of this observational study.

Girls who are more physically active in childhood may have better lung function in adolescence
A study of more than 2,300 adolescents underscores the pulmonary health benefits of physical activity.

Exposure to chemicals before and after birth is associated with a decrease in lung function
A European study, published in The Lancet Planetary Health, analyses for the first time the impact of the exposome on respiratory health.

Common e-cigarette chemical flavorings may impair lung function
Two chemicals widely used to flavor electronic cigarettes may be impairing the function of cilia in the human airway, according to a new study led by Harvard T.H.

Read More: Lung Function News and Lung Function Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.