Thermal ablation benefits confirmed: STEP-UP


27 Jul 2016

Targeted thermal vapour ablation of severely emphysematous lung tissue improves lung function and quality of life with an acceptable safety profile, 12 month results of the joint Australian-European STEP-UP study confirm.

As reported by the limbic, six-month results from the study of 70 patients with severe, upper lobe-prominent emphysema who were randomised the ablation or usual care found FEV1 had improved by 14.7% and St George’s Respiratory Questionnaire Scores had improved by 9.7 points in the ablation group (changes of 12% and 8 points, respectively, are considered clinically meaningful).

At the time Professor Greg Snell, from the Alfred Hospital in Melbourne, who contributed to STEP-UP said: “Although the trial had specific, tight selection criteria, the findings would apply to many Australian emphysema patients with patterns of disease not easily treated by any other means.”

“In addition, it may be possible to repeat treatments, but further trials will help clarify this,” he told the limbic.

“It’s reasonable to imagine more widespread use of such technology with the aim of improving quality of life and eventually – we hope – length of life.”

The latest 12-month results published in The Lancet Respiratory Medicine showed a between group difference of 12·8% (p=0·0039) for FEV1 and –12·1 units (p=0·0021) for SGRQ at 12 months.

“These 12 month controlled results reinforce the conclusion of the original manuscript. Compared with standard medical management, targeted thermal vapour ablation of more diseased segments and preservation of less diseased segments resulted in clinically meaningful and statistically significant improvements in lung function and quality of life at 6 months and 12 months, with an acceptable safety profile,” the study authors concluded.

Although the procedure is theoretically available in Australia, it is not yet funded by Medicare. The Prince Charles Hospital in Brisbane and Sir Charles Gairdner Hospital in Perth also participated in the trial.

Related story: Thermal vapour ablation effective in severe emphysema

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