COPD Treatment with Targeted Lung Denervation Found Safe and Feasible, Study Reports

COPD Treatment with Targeted Lung Denervation Found Safe and Feasible, Study Reports

Treatment of chronic obstructive pulmonary disease (COPD) with a minimally invasive investigative procedure called targeted lung denervation (TLD) is feasible, safe, and was found to improve lung function, according to researchers.

Their study, “Long-term safety of bilateral targeted lung denervation in patients with COPD,” was published in the International Journal of Chronic Obstructive Pulmonary Disease.

COPD treatment requires new approaches providing durable health improvements, despite the current availability of options such as bronchodilators or inhaled glucocorticosteroids.

However, the use of alternative options still requires the evaluation of long-term safety before the start of larger clinical trials.

TLD is a new therapy candidate for COPD. It involves passing a special catheter through a bronchoscope into the lungs, which, through a type of electrical energy called radiofrequency, interrupts nerve transmission outside the main bronchi.

By disrupting nerve transmission, TLD aims to dilate the bronchi (bronchodilation) permanently, reduce mucus production, and decrease airway inflammation through a reduction in the release of the neurotransmitter acetylcholine, which is known to influence airway muscle tone, mucus secretion, and inflammation.

A previous pilot study in 22 COPD patients reported that TLD in both lungs in a sequential fashion was feasible, safe, and well-tolerated.

Now, researchers conducted a multicenter study in 15 patients (47% men, mean age 63.2) with moderate to severe COPD to evaluate the safety of treating both lungs with TLD during a single procedure.

The team hypothesized that this approach would be beneficial over staging, primarily due to the reduced exposure to anesthesia and lesser risk of exacerbations caused by bronchoscopy.

The team also evaluated three-year follow-up data in treated patients to have a first look at the potential long-term effects of targeted lung denervation.

Among the parameters analyzed were:

  • Absence of sustained worsening of COPD directly attributable to TLD up to one year after treatment;
  • Technical feasibility;
  • Change in pulmonary function;
  • Exercise capacity;
  • Health-related quality of life issues.

Results showed that TLD took approximately 89 minutes. No patients showed worsening of their COPD, and there were no reported complications from the TLD procedure. Also, the rate of COPD exacerbations over three years was low.

Tests of lung function and exercise capacity showed that targeted lung denervation without bronchodilators led to similar benefits as long-acting inhaled anticholinergic therapy (a COPD treatment) at 30 days, 180 days, 365 days, two years, and three years post-TLD treatment.

However, no consistent benefits in health-related quality of life were observed.

A total of 12 serious adverse events were reported over three years of follow-up, five of which were respiratory-related. No event was related to TLD.

“TLD delivered to both lungs in a single procedure is feasible and safe with few respiratory-related adverse events through 3 years,“ the researchers wrote, adding that “the overall low rate of severe COPD exacerbations during the follow-up period of up to 3 years appears noteworthy.”

According to the team, future research should focus on optimizing the energy dose, refining the procedure, and identifying patients most likely to benefit from targeted lung denervation.

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4 comments

  1. barry lee says:

    I asked my g p about targeted lung denervation and he had not heard of it I findit difficult to get my doctor to refer me to a consultant

    • r m says:

      I, too, have asked my doctor about some of these procedures read about on this site and my doctor heard of none of them. That leads me to ask, are these real?

  2. Brenda Wells says:

    Yes, I had the same problem with my dr. Finally asked them to refer me to Duke. It was a completely different world. These people knew what they were talking about. I was inquiring about the zephry valve and targeted lung denervation process.
    He changed my meds and I am so much better now. Going back in four months to discuss options; zephyr valve, lung reduction, etc. I would recommend seeing a research facility near you. It was a five hour drive for me but totally worth it…

    • Rod says:

      Hi Brenda,

      It’s good to hear that you’re improving. Would you please provide me with the contact information for the folks you were referred to?

      Thanks,
      Rod Jensen

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