Drug-coated stent can relieve emphysema symptoms

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NEW YORK, Oct 23 (Reuters) Treatment with a stent coated with the drug paclitaxel to reduce hyperinflation of the lungs appears to be a feasible treatment for patients with severe emphysema, according to the results of a small study. This treatment can improve lung function and reduce shortness of breath, according to the results of small study.

''These results indicate that airway bypass is a potentially viable therapeutic option for patients with marked severe pulmonary destruction, whose only current option may be to wait for a lung transplant,'' lead author Dr Paulo F G Cardoso, from Santa Casa de Porto Alegre-Pavilhao Pereira Filho Hospital in Brazil, said in a statement.

Airway bypass along with less invasive treatments to relieve symptoms in patients with advanced disease, ''may ultimately improve quality of life for patients with very severe disease or even those in the transplant waiting lists,'' he commented to Reuters Health.

Cardoso added that airway bypass is a particularly important advance for patients with ''more uniform destruction of the lung'' because usually their only option is a lung transplant.

The stents are placed through the airway walls to release the air trapped in diseased segments of the lung, allowing it to be expelled normally, Cardoso and colleagues' explained in their report, published in The Journal of Thoracic and Cardiovascular Surgery.

Airway bypass was first shown to be feasible in 2003, when researchers tested the procedure on diseased lung removed from emphysema patients. The focus then shifted to maintaining the opening of the stented segments, which led researchers to consider the use of drug-coated stents.

Stents are tiny wire mesh tubes used to prop open diseased heart arteries. This type of stent which releases a drug to keep the artery open - is also used in heart patients to keep the vessels open after they are cleared of the clog-forming plaque that can cause heart attacks.

In the current feasibility study, Cardoso's team assessed the safety and efficacy of airway bypass in 35 patients with severe emphysema. The ''Exhale'' paclitaxel-coated stent used by the researchers was developed by Broncus Technologies, Inc, which funded the study.

About eight stents were implanted in each patient. At 6-month follow-up, the average lung volume had fallen by 400 milliliters from 5.34 liter when the study began. Stent placement was also associated with a significant improvement in shortness of breath.

The authors noted that patients with the most severe hyperinflation prior to treatment gained the greatest benefit from airway bypass. In this group, the average volume had dropped by 870 milliliters by the 6-month evaluation from a starting volume of 5.92 liters.

''The data from the study are very exciting, as they help build the case that airway bypass might reduce hyperinflation and have long-term benefit,'' Dr Cary Cole, CEO of Broncus, said in a statement. ''We hope to continue this success with the current, pivotal EASE Trial, our largest clinical study to date.'' REUTERS ARB RK0905

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