Targeted lung denervation lowers COPD exacerbations, improves quality of life over 2 years
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Key takeaways:
- At the moment, targeted lung denervation as a treatment for COPD has only been performed in research.
- Quality of life and COPD symptoms improved in the 2 years following this treatment.
SAN DIEGO — Patients with COPD treated with targeted lung denervation along with optimal COPD therapy experienced fewer exacerbations over 2 years, according to research presented at the American Thoracic Society International Conference.
Targeted lung denervation (Nuvaira Inc.) has “only [been] done in research setting to date,” Gerard J. Criner, MD, FACP, FACCP, chair and professor of thoracic medicine and surgery at Lewis Katz School of Medicine at Temple University and director of the Temple Lung Center, told Healio.
Using data from the AIRFLOW-3 open-label treatment cohort, Criner and colleagues assessed 76 patients (mean age, 67 years) with COPD in the U.S., E.U. and U.K. who previously smoked (53.1 mean pack-year smoking history) to determine the impact of targeted lung denervation treatment on the annualized acute exacerbation rate at a 2-year follow-up.
Researchers explained in the abstract that targeted lung denervation is when “radiofrequency energy is delivered bronchoscopically to the main bronchi to disrupt the pulmonary parasympathetic nerves and reduce neural hyperactivity.”
As Healio previously reported, the AIRFLOW-2 study revealed that targeted lung denervation plus optimal pharmacotherapy was associated with fewer respiratory events including exacerbations compared with pharmacotherapy alone in patients with COPD.
Notably, with optimal medical therapy, patients in the open-label treatment cohort had symptomatic COPD, or a COPD Assessment Test (CAT) score of at least 10; moderate to very severe airflow obstruction, or GOLD stage II to IV (25% ≤ FEV1 ≤ 80%, FEV1/FVC < 0.7); and GOLD E status, which meant that in the past 12 months, they experienced either two moderate exacerbations or one severe exacerbation.
At baseline, researchers observed an average St. George’s Respiratory Questionnaire for COPD (SGRQ-C) score of 57 points out of 100 and a CAT score of 22.8 points out of 40, both of which are elevated scores that indicate poorer quality of life and greater disease impact, respectively.
Hospitalization in the past year because of a COPD exacerbation was found for 46% of the total cohort, according to researchers.
Further, receipt of triple therapy that includes a long-acting muscarinic antagonist, a long-acting beta agonist and an inhaled corticosteroid was common among patients (> 90%) when evaluated at baseline and 2 years.
As time progressed from the start of targeted lung denervation treatment, the annualized rate of acute COPD exacerbations decreased from 2.97 events per year at baseline to 1.56 events per year at 1 year and to 1.2 events per year at 2 years.
At the 1-year follow-up visit, 79% of patients had fewer moderate acute COPD exacerbations vs. the year before targeted lung denervation. At the 2-year visit, this proportion of patients stayed high at 88%.
The proportion of patients that achieved a lower number of severe acute COPD exacerbations vs. the year before targeted lung denervation was similar at the 1-year follow-up (80%) and the 2-year follow-up (79%), according to researchers.
Researchers also assessed changes in baseline SGRQ-C and CAT scores over 2 years. From baseline, SGRQ-C scores dropped by 7.5 points at the 1-year follow-up (n = 62) and by 6.7 points at the 2-year follow-up (n = 42).
Changes in CAT scores from baseline at 1 year (–4.1 points) and 2 years (–3.5 points) also signaled improvement.
When asked about the study results, Criner told Healio the findings were “encouraging and what we hoped to see.”
Phase 3 trial data is coming late 2024, according to Criner.
“The pivotal study is now completing follow-up with final data, which will be available late fall/early winter this year,” Criner said.