Pre-treatment lung function decline stabilizes up to 3 year after targeted lung denervation in COPD

Abstract

Introduction: Targeted lung denervation (TLD) is a novel bronchoscopic treatment for COPD GOLD-D patients, specifically targeting the pulmonary parasympathetic nerves. TLD has shown a positive effect on the occurrence of COPD exacerbations. As frequent COPD exacerbations are related to a more rapid lung function decline we were interested in lung function decline before and after TLD. Aim: To investigate the annual decline in FEV1 before and up to 3 year after TLD. Methods: COPD patients were included who underwent TLD in our hospital in the AIRFLOW trial (NCT02058459) and who completed their 3 year follow up visit. All available previous spirometry results from their referring hospitals were collected. Results: Fourteen patients (6 male, mean age 62 years,FEV1 32%predicted) were included. We obtained pre-treatment results of 11 patients in which the mean FEV1 decline before treatment was -57mL per year. Three years after treatment the mean decrease in FEV1 compared to baseline was -24mL per year (See Figure). Conclusions: Our results show that the lung function remains stable up to 3 year after TLD and that the annual decline in FEV1 is significantly less compared to before treatment. The stabilization of FEV1 may be a positive result of the previously reported decrease in COPD exacerbations. The currently executed large clinical trial with 5 year follow up (Airflow-3, NCT03639051) will need to confirm our results.