Two-year outcomes for the double-blind, randomized, sham-controlled study of targeted lung denervation in patients with moderate to severe COPD: AIRFLOW-2

Purpose: COPD exacerbations are associated with worsening clinical outcomes and increased healthcare costs, despite use of optimal medical therapy. A novel bronchoscopic therapy, targeted lung denervation (TLD), which disrupts parasympathetic pulmonary innervation of the lung, has been developed to...

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Hauptverfasser: Valipour, Arschang (VerfasserIn) , Shah, Pallav (VerfasserIn) , Herth, Felix (VerfasserIn) , Pison, Christophe (VerfasserIn) , Schumann, Christian (VerfasserIn) , Hübner, Ralf-Harto (VerfasserIn) , Bonta, Peter I. (VerfasserIn) , Kessler, Romain (VerfasserIn) , Gesierich, Wolfgang (VerfasserIn) , Darwiche, Kaid (VerfasserIn) , Lamprecht, Bernd (VerfasserIn) , Perez, Thierry (VerfasserIn) , Skowasch, Dirk (VerfasserIn) , Deslee, Gaetan (VerfasserIn) , Marceau, Armelle (VerfasserIn) , Sciurba, Frank C. (VerfasserIn) , Gosens, Reinoud (VerfasserIn) , Hartman, Jorine E. (VerfasserIn) , Conway, Francesca (VerfasserIn) , Duller, Marina (VerfasserIn) , Mayse, Martin (VerfasserIn) , Norman, Holly S. (VerfasserIn) , Slebos, Dirk-Jan (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 5 November 2020
In: The International journal of chronic obstructive pulmonary disease
Year: 2020, Jahrgang: 15, Pages: 2807-2816
ISSN:1178-2005
DOI:10.2147/COPD.S267409
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.2147/COPD.S267409
Verlag, lizenzpflichtig, Volltext: https://www.dovepress.com/two-year-outcomes-for-the-double-blind-randomized-sham-controlled-stud-peer-reviewed-article-COPD
Volltext
Verfasserangaben:Arschang Valipour, Pallav L Shah, Felix J Herth, Christophe Pison, Christian Schumann, Ralf-Harto Hubner, Peter Bonta, Romain Kessler, Wolfgang Gesierich, Kaid Darwiche, Bernd Lamprecht, Thierry Perez, Dirk Skowasch, Gaetan Deslee, Armelle Marceau, Frank C Sciurba, Reinoud Gosens, Jorine E Hartman, Francesca Conway, Marina Duller, Martin Mayse, Holly S Norman, Dirk-Jan Slebos on behalf of the AIRFLOW-2 Trial Study Group

MARC

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520 |a Purpose: COPD exacerbations are associated with worsening clinical outcomes and increased healthcare costs, despite use of optimal medical therapy. A novel bronchoscopic therapy, targeted lung denervation (TLD), which disrupts parasympathetic pulmonary innervation of the lung, has been developed to reduce clinical consequences of cholinergic hyperactivity and its impact on COPD exacerbations. The AIRFLOW-2 study assessed the durability of safety and efficacy of TLD additive to optimal drug therapy compared to sham bronchoscopy and optimal drug therapy alone in subjects with moderate-to-severe, symptomatic COPD two years post randomization. Patients and Methods: TLD was performed in COPD patients (FEV1 30-60% predicted, CAT >= 10 or mMRC >= 2) in a 1:1 randomized, sham-controlled, double-blinded multicenter study (AIRFLOW-2) using a novel lung denervation system (Nuvaira, Inc., USA). Subjects remained blinded until their 12.5-month follow-up visit when control subjects were offered the opportunity to undergo TLD. A time-to-first-event analysis on moderate and severe and severe exacerbations of COPD was performed. Results: Eighty-two subjects (FEV1 41.6 +/- 7.4% predicted, 50.0% male, age 63.7 +/- 6.8 yrs, 24% with prior year respiratory hospitalization) were randomized. Time-to-first severe COPD exacerbation was significantly lengthened in the TLD arm (p=0.04, HR=0.38) at 2 years post-TLD therapy and trended towards similar attenuation for moderate and severe COPD exacerbations (p=0.18, HR=0.71). No significant changes in lung function or SGRQ-C were found 2 years post randomization between groups. Conclusion: In a randomized trial, TLD demonstrated a durable effect of significantly lower risk of severe AECOPD over 2 years. Further, lung function and quality of life remained stable following TLD. 
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