One-year outcome after endobronchial valve treatment of chronic obstructive pulmonary disease - a nationwide real-life cohort study.

BACKGROUND

The efficacy of endobronchial valve (EBV) treatment has been demonstrated in randomized controlled trials. However, real-life nationwide data from more heterogeneous patient populations remains limited. Therefore, this study aims to evaluate the one-year outcome of EBV treatment in a nationwide cohort study.

METHOD: In this nationwide cohort study, Danish patients treated with endobronchial valves from 2017-2024 were included. Outcomes, such as lung function, exercise capacity, and dyspnea, were assessed at 3 and 12 months, together with data on complications and mortality. Data was obtained from electronic medical records.

RESULTS

A total of 232 patients were included in the study. Follow-up visits at 3 (1-5) and 12 (9-18) months were available for 189 and 165 patients, respectively. Nine patients died within the first year, and 37 patients underwent valve removal. Significant improvements from baseline were observed at both follow-up points in lung function (forced expiratory volume in 1 second +4.75%points & +3.43%points, residual volume -30.5%points & -27.7%points, total lung capacity -7.0%points & -5.7%points), physical ability (6-minute walk distance +30.6 m & +20.8 m), and dyspnea (Medical Research Council dyspnea scale -0.73 & -0.47). Responder rates declined over time, but 40-50% of patients maintained a clinically meaningful benefit at the 12-month visit. Revision bronchoscopies were performed in 44% of the patients.

CONCLUSIONS

Endobronchial valve treatment is associated with statistically significant improvements in lung function, exercise capacity, and dyspnea at both 3 and 12 months, with considerable inter-individual variability.