Breakthrough for thousands of suffering from COPD: New tiny valve offering a breath of fresh air for lung patients with the disease which kills 30,000 people annually

• Health chiefs now recommend the pioneering new lung treatment on the NHS
• Patients undergoing the procedure have seen their lung function triple 
• Before treatment, COPD sufferers found it difficult to walk or even talk 
• A clinical trial noted that patients fitted with the new valve improved their health 

Thousands of Britons suffering from debilitating breathlessness could find relief thanks to a tiny valve implanted into the lungs.

The procedure aims to treat emphysema, one of two forms of chronic obstructive pulmonary disease (COPD) that affects more than a million Britons every year and which is responsible for 30,000 deaths annually.

Health chiefs have now recommended that the procedure is offered routinely on the NHS after patients in a trial saw their lung function triple. The improvement meant they were able once again to walk, talk and complete household chores, all of which had been difficult or impossible before surgery.

Colin Gregg, 74, pictured with his wife Paula, left, is one of the million people in Britain suffering from COPD. But Mr Gregg, from Egbaston, Birmingham has had the pioneering new treatment

Breathlessness remained at a minimum a year after the procedure, which wasn’t seen in patients treated with medication alone.

The implant is a one-way valve which stops airflow into the diseased region of a lung, while simultaneously providing an escape route for harmful fluids and gas.

In the first major study into the procedure, the Royal Brompton and Chelsea & Westminster hospitals in London found that the valve, known as Zephyr, allowed healthier regions to expand and function more efficiently.

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The trial also found that fewer patients needed hospital treatment over a year following treatment, according to results published in the American Journal of Respiratory and Critical Care Medicine.

Professor Pallav Shah, consultant physician in respiratory medicine at the Royal Brompton and principal investigator, said: ‘The new trial validates what several smaller studies have previously shown – that Zephyr valves help patients become significantly less breathless and more active, improving the overall quality of their life.’

The pioneering new treatment could help reduce the 30,000 people a year killed by COPD

The National Institute for Clinical Health and Excellence (NICE) has now updated its guidance so that severe emphysema patients can routinely be referred for treatment on the NHS, after trials found the valves improved patients’ quality of life, exercise capacity and lung function, and were safe long term.

Emphysema occurs when lungs become progressively damaged and the air sacs, which absorb oxygen, stop functioning properly.

The lungs become less elastic, so stale air ‘clogs up’ the lungs – patients cannot exhale stale air, or breathe in enough fresh air. Doctors can offer lung volume reduction surgery – the removal of parts of the lungs – or use implants to close them off. But it is a drastic option: a third of patients spend days in intensive care afterwards, and a small percentage do not survive the procedure.

The new Zephyr valves are between four and seven millimetres long and are shaped a little like a shuttlecock. They comprise a nickel and titanium alloy wire exterior and soft silicone inner tube.

A minuscule opening at the end of the wire basket opens and closes intermittently, providing a one-way escape route for troublesome air and fluid in the malfunctioning section of lung.

Typically patients will be given two or more valves to block off diseased lung sections, and one or both lungs can be treated. The valves are placed via a bronchoscope – a tube with a camera at the end of it – threaded into the lungs via the mouth, so there are no incisions.

‘Occasionally, with any lung reduction method, patients can feel more breathless afterwards and this means we’re able to reverse the procedure,’ explains Prof Shah. ‘Results are comparable to lung volume reduction surgery but with far fewer risks.’ The valves are suitable for about a quarter of severe emphysema patients – in some cases, the lung damage is too widespread for the implants to make a difference.

Colin Gregg, 74, a company director from Edgbaston, Birmingham, smoked 40 cigarettes a day until he started struggling for breath and gave up 12 years ago.

‘But my condition didn’t improve, so I saw my GP and was diagnosed with COPD,’ he says. ‘I’d been a builder in my 20s, pulling down ceilings covered in soot and dust, which probably made it worse.’

He used inhalers at first but still struggled: ‘I’d climb a flight of stairs and be fighting for breath. And I couldn’t manage hills on the golf course – I’d have to use buggies. The condition is like taking a deep breath and not being able to breathe out again, so it’s impossible to get more fresh air into your lungs. It is horrible.’

Doctors at the Royal Brompton diagnosed emphysema and told him about the Zephyr trial.

In July 2016, Colin had four valves implanted into one lung during a 45-minute procedure.

Tests later showed that his breathing had vastly improved: ‘I could climb stairs without gasping for breath, and getting around the golf course was much easier,’ he admits.

‘It has given me a much better quality of life – and since it’s a degenerative condition, I’m now thinking of having the other lung done. I’m delighted to hear this procedure will now be offered to so many more patients like me.’

 

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