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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EA study of a nonsurgical lung volume reduction approach using an emphysematous lung sealant (ELS) demonstrated that \u0026gt;50% of treated patients experienced minimal, clinically important differences in health status and respiratory measures compared with patients treated only with optimal medical therapy. However, the rate of serious adverse events was higher in patients who responded to ELS treatment. The Study of the AeriSeal System for Hyperinflation Reduction in Emphysema [ASPIRE; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01449292\u0026amp;atom=%2Fspmdc%2F14%2F11%2F16.atom\u0022\u003ENCT01449292\u003C\/a\u003E; Washko GR et al. \u003Cem\u003EAm J Respir Crit Care Med\u003C\/em\u003E 2014] was terminated early for financial reasons.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ELower Respiratory Infections\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPulmonary Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ELower Respiratory Infections\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPulmonary Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPulmonary \u0026amp; Critical Care\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EA study of a nonsurgical lung volume reduction (LVR) approach using an emphysematous lung sealant (ELS) demonstrated that \u0026gt;50% of treated patients experienced minimal, clinically important differences in health status and respiratory measures compared with patients treated only with optimal medical therapy. However, the rate of serious adverse events (SAEs) was higher in patients who responded to ELS treatment. The Study of the AeriSeal System for Hyperinflation Reduction in Emphysema [ASPIRE; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01449292\u0026amp;atom=%2Fspmdc%2F14%2F11%2F16.atom\u0022\u003ENCT01449292\u003C\/a\u003E; Washko GR et al. \u003Cem\u003EAm J Respir Crit Care Med\u003C\/em\u003E 2014] was terminated early for financial reasons. George Washko, MD, Brigham and Women\u0027s Hospital, Boston, Massachusetts, USA, presented data on the 90 patients who completed the 3- and the 6-month follow-up.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe multicenter, multinational, randomized, controlled trial used ELS, a synthetic polymer that targets the alveolar compartment of the lung to block the distal airways and collateral ventilation, to achieve nonresectional inflation in patients with hyperinflation. The goal was to achieve the clinical and physiologic benefit of LVR without the morbidity and mortality associated with surgery. In ASPIRE, 2 subsegments each in the right and upper left lobes were treated endoscopically with ELS, and patients were hospitalized overnight for observation.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe study patients had upper lobe\u2013predominant emphysema, with forced expiratory volume in 1 second (FEV\u003Csub\u003E1\u003C\/sub\u003E) \u0026lt;50%, total lung capacity \u0026gt;100%, and a diffusing capacity of the lungs for carbon monoxide of 20% to 60%. In total, 95 patients were randomized to optimal medical therapy plus ELS (ELS treated; n=61) or optimal medical therapy alone (control; n=34). Their mean age was 65 years, most were men (\u223c60%), and they had smoking histories of \u0026gt;20 pack-years. Patients with a\u003Csub\u003E1\u003C\/sub\u003E antitrypsin deficiency, a genetic risk factor for emphysema, and those who had prior LVR were excluded.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary outcome was change in FEV\u003Csub\u003E1\u003C\/sub\u003E at 12 months from baseline. Data were available at 3 months for 34 ELS-treated and 23 control patients and at 6 months for 21 ELS-treated and 13 control patients. The changes in FEV\u003Csub\u003E1\u003C\/sub\u003E in the ELS-treated patients were +11% and +19% at 3 and 6 months, compared with \u22122% and +1% in the control patients, respectively. The change in health status as measured by the St. George\u0027s Respiratory Questionnaire, a secondary end point, was \u221211 and \u221212 at 3 and 6 months in the ELS-treated patients and \u22124 and \u22123, respectively, in the control patients. The change in the Modified Medical Research Council dyspnea scale was small: \u22121 at 3 and 6 months in the ELS-treated and 0 at both time points in the control patients.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe rate of all SAEs was higher for the ELS-treated than for control patients, with 43% and 16%, respectively, requiring hospitalization, primarily for respiratory SAEs (39% of treatment and 15% of control patients). Two patients in the treatment group died (1 treatment related).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe individual patient data at 6 months showed that the improvement in FEV\u003Csub\u003E1\u003C\/sub\u003E ranged from a nearly 25% reduction to an approximately 120% increase in the ELS-treated patients. The median change in FEV\u003Csub\u003E1\u003C\/sub\u003E was approximately 19% and the mean change was approximately 28% in the ELS-treated patients, which is comparable with surgical LVR outcomes, stated Dr. Washko.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/11\/16.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp203\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}