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EASE Trial: Exhale Airway Stents for Emphysema

Phase 3
Conditions
Emphysema
Interventions
Device: Sham control
Device: Exhale® Drug-Eluting Stent
Registration Number
NCT00391612
Lead Sponsor
Broncus Technologies
Brief Summary

This is an international clinical research study evaluating the safety and effectiveness of a new procedure called airway bypass. The goal of this research is to see if airway bypass can relieve hyperinflation (overfilling) of the lungs, thereby improving lung function and reducing shortness of breath in patients with severe homogeneous (diffuse) emphysema. "EASE" stands for Exhale Airway Stents for Emphysema.

Detailed Description

Over 3 million people in the United States and tens of millions more throughout the world live with emphysema, a chronic, progressive, irreversible disease of the lungs. The hallmark of emphysema is hyperinflation of the lungs -- air is trapped in the lungs and cannot escape, causing the lungs to become larger and larger. This makes it difficult to breathe and dyspnea (shortness of breath) is the result.

The airway bypass procedure is performed using a bronchoscope with the patient under anesthesia. Very small passageways are created between the damaged lung tissue and the larger breathing passages (airways). Small stents are inserted to keep the new pathways from closing. These pathways could potentially provide a way for the trapped air to escape when the patient exhales. If the amount of air trapped in the lungs is reduced then it should be easier for the person to breathe.

The EASE study will compare the effects of Exhale Drug-Eluting Stents in patients to a sham-control group of patients who do not receive the stents. Two out of three (2/3) of the participants in the trial will be in the airway bypass group, or "treatment" group. Participants in the treatment group will undergo the airway bypass procedure with up to six drug-eluting stents implanted in their lungs, creating the passageways for the trapped air to escape. A smaller group - one out of three (1/3) participants - will be the "control" group. The control group will have bronchoscopy, but passages will not be made and stents will not be implanted.

Participants will need to return to the study center four times during the year for follow-up visits and tests. All participants will be told which group they were in when they come back for a follow-up visit one year after the procedure. Participants in the control group will be finished with the trial after one year. Participants in the treatment group will have a follow-up visit once a year for the next four years to monitor the longer term effects of the airway bypass procedure. This is why the end date of the trial is listed as 2012.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
450
Inclusion Criteria
  1. High resolution computed tomography (CT) scan evidence of homogeneous emphysema.
  2. Stopped smoking at least 8 weeks before entering the trial.
  3. Post-bronchodilator RV/TLC ≥ 0.65.
  4. Post-bronchodilator Forced Expiratory Volume (FEV1) ≤ 50% or FEV1 < 1 liter.
  5. Marked dyspnea, scoring ≥ 2 on the modified Medical Research Council scale of 0-4.
  6. Patient has undergone supervised pulmonary rehabilitation of 16-20 sessions over 6-10 weeks.
Exclusion Criteria
  1. Change in FEV1 > 20% pre- and post- bronchodilator measurements or > 200 ml if post-bronchodilator FEV1 < 1 liter.
  2. Respiratory infections requiring 3 or more hospitalizations in past year.
  3. Inability to walk > 140 meters (150 yards) in 6 minutes.
  4. Previous lung volume reduction surgery (LVRS) or lobectomy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2Sham controlsubject receives optimal medical management, supervised pulmonary rehabilitation therapy and undergoes bronchoscopy but no stents are placed
1Exhale® Drug-Eluting Stentsubject receives optimal medical management, supervised pulmonary rehabilitation therapy and undergoes bronchoscopy during which up to six Exhale drug-eluting stents are placed in the lungs
Primary Outcome Measures
NameTimeMethod
Forced Vital Capacity (FVC)6 months
modified Medical Research Council (mMRC) score (breathlessness)6 months
Secondary Outcome Measures
NameTimeMethod
Residual Volume/Total Lung Capacity (RV/TLC)6 months
Forced Vital Capacity (FVC)6 months
modified Medical Research Council Dyspnea Scale (mMRC)6 months
Forced Expiratory Volume in 1 second (FEV1)6 months
St. George's Respiratory Questionnaire (SGRQ)6 months
6-minute walk (6MW)6 months
Cycle Ergometry6 months
Note: Residual Volume/Total Lung Capacity (RV/TLC) will be analyzed for superiority. All other secondary endpoints will be analyzed for informational purposes.6 months
Residual Volume (RV)6 months

Trial Locations

Locations (37)

University of Southern California

🇺🇸

Los Angeles, California, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

University of Pennsylvania Health System

🇺🇸

Philadelphia, Pennsylvania, United States

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

Cedars-Sinai Medical Center

🇺🇸

Los Angeles, California, United States

International Heart Institute of Montana Foundation

🇺🇸

Missoula, Montana, United States

New York Methodist Hospital

🇺🇸

Brooklyn, New York, United States

UCSF-Fresno

🇺🇸

Fresno, California, United States

University of California, Davis Medical Center

🇺🇸

Sacramento, California, United States

New York University - Bellevue Hospital

🇺🇸

New York, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Pulmonary and Critical Care Associates of Baltimore

🇺🇸

Baltimore, Maryland, United States

Santa Casa Hospital

🇧🇷

Porto Alegre, Rio Grande do Sul, Brazil

Topeka Pulmonary/Veritas Clinical Specialties, LTD

🇺🇸

Topeka, Kansas, United States

Pulmonary Associates, PA

🇺🇸

Phoenix, Arizona, United States

National Jewish Medical and Research Center

🇺🇸

Denver, Colorado, United States

Henry Ford Hospital & Medical Center

🇺🇸

Detroit, Michigan, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Peoria Pulmonary Associates, LTD

🇺🇸

Peoria, Illinois, United States

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Emory Healthcare

🇺🇸

Atlanta, Georgia, United States

Southern Illinois University School of Medicine

🇺🇸

Springfield, Illinois, United States

Sarasota Memorial Health Care System

🇺🇸

Sarasota, Florida, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Chicago Chest Center at Central DuPage Hospital

🇺🇸

Winfield, Illinois, United States

Sentara Norfolk General Hospital

🇺🇸

Norfolk, Virginia, United States

The Alfred Hospital

🇦🇺

Melbourne, Victoria, Australia

Otto Wagner Hospital

🇦🇹

Vienna, Austria

Hopital Laval

🇨🇦

Quebec, Canada

University Medical Center, Groningen

🇳🇱

Groningen, Netherlands

Papworth Hospital

🇬🇧

Cambridge, United Kingdom

London Health Sciences Centre

🇨🇦

London, Ontario, Canada

Mater Misericordiae University Hospital

🇮🇪

Dublin, Ireland

Universitatsklinik des Saarlandes

🇩🇪

Homburg, Saar, Germany

The Royal Brompton Hospital

🇬🇧

London, United Kingdom

Fundación Jiménez Díaz

🇪🇸

Madrid, Spain

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