Targeted Lung Denervation Lowers COPD Respiratory Events

Patients with chronic obstructive pulmonary disease (COPD) who underwent targeted lung denervation experienced 50% fewer lung-related problems compared with patients who received sham treatment, according to early study results recently presented the European Respiratory Society International Congress.  

“We have been able to significantly reduce chronic respiratory symptoms such as shortness of breath, exacerbations of the disease, infections, and hospitalizations in a group of COPD patients who are already on aggressive medical therapy. There was also a trend towards improved quality of life and better lung function in the treated patients,” said Dirk-Jan Slebos, MD, PhD, of the University Medical Centre Groningen in the Netherlands, according to a European Lung Foundation press release. “This has important implications for patient quality of life and also healthcare costs, as these are events that have a significant impact on the cost of caring for these patients.”

Dr Slebos shared initial study results for 82 patients from the ongoing AIRFLOW 2 phase 2 clinical trial. The double-blind study randomized some patients to targeted lung denervation, a surgical procedure that involves inserting a bronchoscope and catheter into the lungs and delivering a radiofrequency energy charge in an effort to relax and widen airways, decrease mucus production, and decrease inflammation. Others received sham treatment that involved inserting the bronchoscope and catheter but no radiofrequency energy charge. All patients also received the anticholinergic bronchodilator tiotropium.

According to the results presented, 71% of patients who received sham treatment had an adverse respiratory event related to COPD 3 to 6 months post-procedure compared with just 32% of patients who received targeted lung denervation.

“Furthermore, the positive benefit has continued in those receiving targeted lung denervation treatment,” added Dr Slebos, “with the number of patients hospitalized for respiratory complications in the first year reduced by more than half in the treatment arm versus the sham arm.”

No adverse side effects requiring treatment were reported with targeted lung denervation. Stomach problems such as nausea and abdominal bloating were experienced by 12% of patients who received the active treatment, but they resolved after 6 months. Dr Slebos said the symptoms were caused by radiofrequency energy that affected gastric nerves and that additional measures have been implemented to better avoid them going forward.

A larger, phase 3 trial further investigating target lung denervation in patients for COPD is expected to begin next year.

—Jolynn Tumolo

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