Abstract
The results of the randomised controlled trials investigating the bronchoscopic lung volume reduction treatment using endobronchial valves (EBV) are promising, and have led to their inclusion in treatment guidelines, US Food and Drug Administration approval and inclusion in routine care in an increasing number of countries. The one-way valve treatment has advanced and is now a regular treatment option. However, this new phase will lead to new challenges in terms of implementation. We believe that key issues in future research concern advanced patient selection, improved methods for target lobe selection, increased knowledge on the predictive risk of a pneumothorax, positioning of pulmonary rehabilitation in conjunction with the EBV treatment, the positioning of lung volume reduction surgery versus EBV treatment, and the long-term efficacy, adverse events, impact on exacerbations and hospitalisations, costs and survival. Hopefully, the increasing number of patients treated, the setup of (inter)national registries and future research efforts will further optimise all aspects of this treatment.
Abstract
EBV treatment for severe emphysema patients improves clinical and patient reported outcomes and has become a guideline treatment, but also has future challenges. http://ow.ly/Jskd30o3ufm
Footnotes
Provenance: Submitted article, peer reviewed.
Conflict of interest: J.E. Hartman has nothing to disclose.
Conflict of interest: L.E.G.W. Vanfleteren reports personal fees from PulmonX, outside the submitted work.
Conflict of interest: E.M. van Rikxoort reports other funding from Thirona, during the conduct of the study.
Conflict of interest: K. Klooster has nothing to disclose.
Conflict of interest: D-J. Slebos reports grants, personal fees, non-financial support and other funding from PulmonX Inc., CA, USA, during the conduct of the study; and grants, personal fees, non-financial support and other funding from PneumRx/BTG, CA, USA, outside the submitted work.
Support statement: All authors received a grant from the Dutch Lung foundation for the SOLVE trial (grant number: 5.1.17.171).
- Received December 20, 2018.
- Accepted March 8, 2019.
- Copyright ©ERS 2019.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.