Dataset Information

Targeted lung denervation for moderate to severe COPD: a pilot study.

ABSTRACT:

Background

Parasympathetic pulmonary nerves release acetylcholine that induces smooth muscle constriction. Disruption of parasympathetic pulmonary nerves improves lung function and COPD symptoms.

Aims

To evaluate 'targeted lung denervation' (TLD), a novel bronchoscopic therapy based on ablation of parasympathetic pulmonary nerves surrounding the main bronchi, as a potential therapy for COPD.

Methods

This 1-year, prospective, multicentre study evaluated TLD in patients with COPD forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (FEV1/FVC <0.70; FEV1 30%-60% predicted). Patients underwent staged TLD at 20 watts (W) or 15 W following baseline assessment off bronchodilators. Assessments were repeated on tiotropium before treatment and off bronchodilators at 30, 90, 180, 270 and 365 days after TLD. The primary endpoint was freedom from documented and sustained worsening of COPD directly attributable to TLD to 1 year. Secondary endpoints included technical feasibility, change in pulmonary function, exercise capacity, and quality of life.

Results

Twenty-two patients were included (n=12 at 20 W, n=10 at 15 W). The procedures were technically feasible 93% of the time. Primary safety endpoint was achieved in 95%. Asymptomatic bronchial wall effects were observed in 3 patients at 20 W. The clinical safety profiles were similar between the two energy doses. At 1 year, changes from baseline in the 20 W dose compared to the 15 W dose were: FEV1 (+11.6%±32.3 vs +0.02%±15.1, p=0.324), submaximal cycle endurance (+6.8 min±12.8 vs 2.6 min±8.7, p=0.277), and St George's Respiratory Questionnaire (-11.1 points ±9.1 vs -0.9 points ±8.6, p=0.044).

Conclusions

Bronchoscopic TLD, based on the concept of ablating parasympathetic pulmonary nerves, was feasible, safe, and well tolerated. Further investigation of this novel therapy is warranted.

Trial registration number

NCT01483534.

SUBMITTER: Slebos DJ

PROVIDER: S-EPMC4413833 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature

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Publications

Targeted lung denervation for moderate to severe COPD: a pilot study.

Slebos Dirk-Jan DJ Klooster Karin K Koegelenberg Coenraad F N CF Theron Johan J Styen Dorothy D Valipour Arschang A Mayse Martin M Bolliger Chris T CT

Thorax 20150304 5

<h4>Background</h4>Parasympathetic pulmonary nerves release acetylcholine that induces smooth muscle constriction. Disruption of parasympathetic pulmonary nerves improves lung function and COPD symptoms.<h4>Aims</h4>To evaluate 'targeted lung denervation' (TLD), a novel bronchoscopic therapy based on ablation of parasympathetic pulmonary nerves surrounding the main bronchi, as a potential therapy for COPD.<h4>Methods</h4>This 1-year, prospective, multicentre study evaluated TLD in patients with ...[more]

PMID: 25739911

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Dataset Information

Targeted lung denervation for moderate to severe COPD: a pilot study.

Background

Aims

Methods

Results

Conclusions

Trial registration number

Publications

Targeted lung denervation for moderate to severe COPD: a pilot study.

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