GOLD Treatment Recommendations Now Include Endobronchial Valves to Manage COPD

Newly updated chronic obstructive pulmonary disease (COPD) management recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) now include the reduction in bronchoscopic lung volume through the use of endobronchial valves as a treatment option for patients suffering with advanced emphysema and absence of collateral ventilation.

The new recommendations are based on evidence from three clinical trials — BeLieVeR-HIFi (ISRCTN04761234), STELVIO (NTR2876), and IMPACT (NCT02025205) — that have demonstrated devices such as the Zephyr EBV, developed and marketed by Pulmonx, significantly improved lung function, exercise tolerance and quality of life in patients with emphysema and absence of collateral ventilation, as assessed by the Chartis System.

According to the GOLD report, “In select patients with advanced emphysema, bronchoscopic interventions reduces end-expiratory lung volume and improves exercise tolerance, health status and lung function 6-12 months following treatment.“

Severe emphysema is a form of COPD, and refers to an abnormal permanent enlargement of the distal airspace and the terminal bronchioles, along with the loss of elasticity of alveolar walls and the supporting structures of the alveoli. Patients develop cough, phlegm production and shortness of breath. As the disease progresses, symptoms worsen and patients often develop fatigue and weakness. An acute exacerbation (worsening of the symptoms) can occur with minimal warning.

Zephyr EBVs are small, minimally-invasive, one-way valves that are placed in selected airways of the lungs to occlude damaged regions and reduce lung hyperinflation. This process results in more efficient functioning of the remaining healthier lung regions, enabling improved breathing capacity and a better quality of life.

“This is the first major update to the GOLD guidance for bronchoscopic interventions, based on recent data,” Felix Herth, head of the Department of Internal Medicine, Pulmonology and Critical Care Medicine, Thoraxklinik Heidelberg, said in a press release. “These interventions offer promise for emphysema patients who continue to suffer symptoms despite optimal pharmacologic management,” Herth said.

Every year GOLD issues a report on recommendations for COPD management based on the best and latest scientific evidence. The report is presented as a “strategy document” for healthcare professionals to use as a tool to implement effective management programs based on available healthcare systems.

“With our tools to help physicians identify the best responders to endobronchial valve treatment, Pulmonx is enabling precision medicine for the treatment of emphysema,” said Glen French, Pulmonx chief executive officer. “We welcome this recognition of the growing body of evidence demonstrating the benefit of EBV treatment for emphysema patients.”

Over the past decade, more than 48,000 Zephyr EBV devices have been implanted in more than 12,000 patients worldwide.