Abstrakt

Rationale: Endoscopic lung volume reduction using endobronchial valves (EBV) is established as an interventional therapy for selected patients with severe emphysema. While previous studies mainly included patients with heterogeneous emphysema, the question rises in what way patients with a homogenous emphysema distribution might benefit from this therapy. Objective: This scientific article presents results from the recently published IMPACT study [1], where patients with homogeneous emphysema were treated with EBV. Methods: Prospective, multicenter, 1 : 1 randomized controlled study comparing EBV therapy plus standard of care (SoC) to standard of care alone. Results: 93 patients with homogeneous emphysema without collateral ventilation (CV) have been randomized. In the treatment group (n = 43), the improvement in FEV₁ was 13.7 ± 28.2% in the EBV group compared to baseline vs. –3.2 ± 13.0% in the SoC group (n = 50): The mean difference between the groups was 17.0% (p = 0.0002). Secondary endpoints also showed significant differences in improvements of the 6-minute walk-test (6-MWT) and quality of life (SGRQ), while those parameters worsened in the control group after 3 months (6-MWT 22.6 ± 66,6 m vs. –17.3 ± 52.8 m and SGRQ –8.6 ± 11.3 points vs. 1.0 ± 19.4 points, respectively). Postoperative pneumothorax occurred in 11 of the EBV treated paEBV tients (25.6%). Conclusions: EBV treatment also leads to clinically meaningful benefits in patients with homogeneous emphysema and absence of collateral ventilation in terms of improved lung function, exercise capacity and quality of life.

Autoreninformation

Autoren

• R. Eberhardt^{1, 2}

Abteilungen

• ¹ Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg,
• ² Translational Lung Research Center (TLRC) Heidelberg, Mitglied des Deutschen Zentrums für Lungenforschung (DZL)

Adresse

Prof. Dr. med. Ralf Eberhardt
Pneumologie und Beatmungsmedizin
Thoraxklinik am Universitätsklinikum Heidelberg
Röntgenstraße 1
69126 Heidelberg
Email: [email protected]

Citation