UK NICE Updates Endobronchial Valve Treatment to Standard Care

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Pulmonx® Corp. tells us that the UK’s National Institute for Health and Care Excellence (NICE) has updated its guidance for endobronchial valves used to treat severe emphysema, an advanced form of chronic obstructive pulmonary disease (COPD), and now considers current evidence sufficient to support routine use.

The British Lung Foundation estimates that in the UK, 1.2 million people are living with diagnosed COPD and almost 30,000 die from the disease every year. Roughly one-third of COPD patients have emphysema, which causes damage to the alveoli. This chronic breathlessness makes even the simplest daily activities difficult, such as washing, eating, walking and household chores, and often leads to patients becoming housebound and depressed. In fact, the quality of life for emphysema patients is worse than that for lung cancer.

Zephyr EBVs are tiny, minimally-invasive, one-way valves placed via a flexible bronchoscope in airways in the lungs to occlude diseased regions and reduce lung hyperinflation. As a result, the remaining healthier regions can function more efficiently, enabling better breathing and an improved quality of life for patients.

Zephyr EBVs are routinely used in Europe and Australia as a treatment for severe emphysema. The treatment has been included in influential international guidelines from such groups as the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The well-known independent Cochrane Airways Group also published a review of the available evidence earlier this year and concluded that, with proper patient selection, bronchoscopic lung volume reduction techniques – such as the Zephyr EBV – should be considered for severe emphysema patients when medical therapy has failed.

Germany and Switzerland have supported EBV use in eligible patients for several years, and late last month, the Dutch organization for reimbursement – the Zorginstituut Nederland – ruled that EBVs are considered an effective treatment in adult patients with severe emphysema and will now be covered by the government.

The change in NICE guidance is based on safety and efficacy data from multiple randomized clinical trials evaluating Zephyr® Endobronchial Valves (EBV®), which have demonstrated benefits for patients in quality of life, exercise capacity and lung function, as well as long-term safety. In fact, four randomized controlled trials of the Zephyr EBV (BeLieVeR-HiFI, TRANSFORM, STELVIO and IMPACT) provide a significant body of evidence supporting the ability of the treatment to significantly improve lung function, exercise tolerance and quality of life in emphysema patients with no collateral ventilation, as assessed with the Chartis System.

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