The UK National Institute for Health and Care Excellence (NICE) guidelines have been updated to support the routine use of endobronchial valves to treat severe emphysema, a condition that severely impairs quality of life. The change was made following the results of multiple clinical trials evaluating the use of Zephyr® Endobronchial Valves (EBV) (Pulmonx, California, USA) that demonstrated the effectiveness of the treatment for this advanced form of chronic obstructive pulmonary disease (COPD).
Zephyr EBV occlude diseased regions and reduce lung hyperinflation, enabling more efficient functioning in remaining healthier regions, which improves breathing and quality of life in patients with severe emphysema. The minimally-invasive, one-way valves work by being placed in the airways of the lungs via a flexible bronchoscope.
Results of Studies
This type of valve is routinely used to treat severe emphysema in Europe and Australia, and last year a review by the Cochrane Airways Group concluded that bronchoscopic lung volume reduction techniques, such as Zephyr EBV, should be considered for patients with this condition when medical therapy has failed. Using the Chartis System, the randomised controlled trials of BeLieVeR-HiFI, TRANSFORM, STELVIO, and IMPACT have displayed significant improvements in lung function, exercise tolerance, and quality of life in emphysema patients with no collateral ventilation.
Access to the Treatment
It is hoped that the NICE decision will ensure that many UK-based severe-emphysema patients have access to endobronchial valve treatment. Dr Pallav Shah, Consultant Physician in Respiratory Medicine, Royal Brompton Hospital and Chelsea & Westminster Hospital, London, UK, commented: “In light of the high burden of symptoms, progressive nature of emphysema, and poor prognosis for patients, the NICE decision means that patients with severe emphysema should be referred to specialists to determine if they are good candidates for endobronchial valves or other interventions.”
James Coker, Reporter
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