News from EFFORTS on Bronchoscopic Lung Volume Reduction

Jean Rommes, a very smart lady with COPD, actively works to help those living with chronic lung disease. She recently attended a meeting discussing Broncho- scopic Lung Volume Reduction (BLVR) and reported what she learned to the members of EFFORTS (www.emphysema.net).

Lung volume reduction surgery (LVRS) involves the removal of portions of the lungs of people with emphysema. It has proven to be of benefit for those who have emphysema localized in sections of their lung, especially the upper sections, rather than throughout the entire lung. If the diseased sections are removed, you are left with lungs that function much better.

As an alternative to surgery, companies have been testing valves and coils to accom- plish the same objective. They are placed in your airway to block off the diseased portions so the air you breathe is directed to your lung that has less emphysema.

Jean listened to speakers from the U.S. and around the world who discussed the options currently available. She learned:

  • heT goal of lung volume reduction is to reduce the effects of hyperinflation. Because the walls of your alveoli (air sacs) are floppy, they are unable to fully empty, stale air gets trapped and builds up, making breathing difficult.

h•eTre are a number of different tech      – niques to do this. Zephyr® and Spiration® EndoBronchial Lung Valves and the RePneu® Lung Volume Reduction Coil are being studied.

Different people will do better with one technique over others, depending on vari- ous presenting parameters: age, co-existing diseases (comorbidities), exercise tolerance, degree of hyperinflation, etc. The poten- tial is that this intervention can be highly personalized.

image119-3unLg structure   and   comorbidities are very important in determining which would be best for  whom.

 

IBV Valve News

Here’s the big news: people with homo- genous rather than large sections emphy- sema do benefit from these interventions. This is huge, especially for people like me, who always assumed that because we are not good candidates for LVRS, we are not good candidates for BLVR. Not true! We are going to benefit from everything learned in other countries when these treatments are finally approved for use

in the U.S.

  • ouYr motivation for such treatment is crucial.
  • alVves work well in people with resid – ual volumes greater than  175  percent of normal and more than 50 percent destruc- tion in the lung.

There’s a technique called Targeted Lung Denervation that is an intervention done in the large bronchial tubes using a tech- nology that targets the same receptors in the airways that Spiriva® and similar meds target. Results in lab animals have been ex-

cellent and they’ll be starting clinical trials on people sometime in the next two years. This is totally different than the placements of vents, valves or coils.

I asked the question when did the panel think the FDA would get around to approv- ing any of these? I was told we needed to gather the troops and testify at the FDA. After the session, the other people with COPD and I were all approached by com- panies whose products are waiting for the FDA to approve.