Last year saw a plethora of COPD research hit the journals but what were the significant findings that could change practice as we know it? In a ‘year in review’ session international expert Dr Craig Hersh from the Brigham and Women’s Hospital in Boston gave #ATS2016 delegates here in San Francisco his take on the highlights.
- Novel endobronchial devices
Bronchoscopic lung-volume reduction in patients with emphysema using one-way endobronchial valves has achieved some success, providing an alternative to surgery, but might be more effective when patients do not have collateral interlobar ventilation, Dr Hersh told the meeting.
The Dutch STELVIO study used a one-way valve that aimed to collapse the targeted lobe as air was expelled.
Compared to patients receiving usual care, those with the valves had better FEV1 and FVC at six months, as well as a 74 metre improvement in 6-minute walk distance.
The cost of these gains was a higher rate of adverse events, including pneumothorax in six of 34 treated patients, of whom five needed a chest tube inserted. Twelve patients required repeat bronchoscopies, and the valves had to be removed in seven.
“The study screened 680 patients to enrol 68, suggesting that only a minority of those with severe COPD will be eligible,” Dr Hersh said.
The larger LIBERATE study of the technique is now in progress.
- Identification of early disease in smokers
Another significant study published in the last year suggested that lung disease and respiratory impairments are common in smokers who do not have COPD according to conventional spirometric criteria.