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Royal Brompton’s pioneering lung treatments receive NICE approval

Pallav Shah - Bronchoscopy.jpg

8 November 2018

Two trailblazing innovations pioneered by Professor Pallav Shah, consultant physician in respiratory medicine have celebrated major milestones.

A bronchial thermoplasty procedure that eases the symptoms of severe asthma, and endobronchial valves, used to treat patients with severe COPD (chronic obstructive pulmonary disease), have been backed by the National Institute for Health and Care Excellence (NICE) and made available to patients on the NHS.

Both procedures are delivered via bronchoscope – a flexible fibre-optic material which is fed into the airways to examine and treat them – to reduce ineffective tissue in the lung; an approach which has been shown to be an effective way of helping patients who struggle for breath.

Both procedures have been featured prominently in the media.

Bronchial thermoplasty

Asthma affects the airways that carry air in and out of the lungs. For those who suffer with the condition, allergens can cause an immune system reaction. This response leads to the lining of the lungs becoming inflamed and swollen, so the airways narrow, making it harder for air to pass through. Asthma is defined as severe when symptoms do not improve with usual treatments.

Bronchial thermoplasty uses a probe which emits heat and shrinks scarred, thickened lung tissue. This means the healthy parts of the lung can expand, which helps patients breathe more easily.

Three 45-minute sessions are required. The lower part of the right lung is treated first, and the lower part of the left three weeks later. A few weeks later a third 45-minute operation treats the upper sections of both lungs.

Professor Shah told the Mail on Sunday: “Clinicians are seeing incredible results; research has shown that bronchial thermoplasty can almost halve the number of severe asthma attacks and cut the average number of emergency hospitalisations in treated patients by over 80 per cent.

“Some of our patients had difficulty walking upstairs, and are now doing intensely physical things like rock-climbing.”

Those who have benefitted include Nicola Kerr, 43, whose asthma was so severe it left her hospitalised. Within two months of having the procedure earlier this year, she completed a 170-mile hike in the French mountains – a feat which would have been unthinkable before.

She said: “Instead of reaching for the inhalers every morning and coughing all day, I now wake up fine. It’s simply changed my life.”

Read the full article about bronchial thermoplasty in the Mail on Sunday online.

Endobronchial valves

A major milestone has also been reached for a trial of Zephyr® endobronchial valves as a treatment for COPD. This condition makes the airways baggy and ineffective, and is responsible for 30,000 deaths a year.

Billed in the media as a ‘breakthrough for thousands of suffering from COPD’, the one-way valve is implanted into the airways and acts as barrier to prevent airflow into the diseased area of the lung, while also providing an escape route for harmful fluids and gas.

A clinical trial led by Professor Shah showed lung function tripled for patients who had received the endobronchial valves, enabling patients to take part in activities they had struggled to before. Follow-ups revealed the treatment was still effective a year after the procedure.

Professor Pallav Shah said: “The new trial validates what several smaller studies have previously shown – that the valves help patients become significantly less breathless and more active, improving the overall quality of their life.”

Colin Gregg, 74, gave up smoking 12 years ago but used to smoke up to 40-a-day. As a result, he had developed COPD and struggled to breathe – his condition was exacerbated by the fact he had previously worked in the dusty environment of construction. 

Colin found his activities seriously hampered by the condition; he was unable get up the stairs without gasping. 

After doctors told him about the endobronchial valve trial, Colin had four valves implanted into one lung during a 45-minute procedure in July 2016.

Tests later showed that his breathing had vastly improved allowing him to climb upstairs without fighting for breath – and even play a round of golf.

Colin said: “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.”

Read the full article on endobronchial valves in the Mail on Sunday online.


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