PMID- 29100445
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240327
IS  - 1949-2553 (Electronic)
IS  - 1949-2553 (Linking)
VI  - 8
IP  - 44
DP  - 2017 Sep 29
TI  - Efficacy and safety of bronchoscopic lung volume reduction therapy in patients 
      with severe emphysema: a meta-analysis of randomized controlled trials.
PG  - 78031-78043
LID - 10.18632/oncotarget.19352 [doi]
AB  - BACKGROUND: Increasing randomized controlled trials (RCTs) indicate that 
      bronchoscopic lung volume reduction (BLVR) is effective for severe emphysema. In 
      this meta-analysis, we investigated the efficacy and safety of BLVR in patients 
      with severe emphysema. METHODS: PubMed, Embase and the Cochrane Library and 
      reference lists of related articles were searched, and RCTs that evaluated BLVR 
      therapy VS conventional therapy were included. Meta-analysis was performed only 
      when included RCTs >/= 2 trials. RESULTS: In total, 3 RCTs for endobronchial coils, 
      6 RCTs for endobronchial valves (EBV) and 2 RCTs for intrabronchial valves (IBV) 
      were included. Compared with conventional therapy, endobronchial coils showed 
      better response in minimal clinically important difference (MCID) for forced 
      expiratory volume in 1s (FEV1) (RR = 2.37, 95% CI = 1.61 - 3.48, p < 0.0001), for 
      6-min walk test (6MWT) (RR = 2.05, 95% CI = 1.18 - 3.53, p = 0.01), and for St. 
      George's Respiratory Questionnaire (SGRQ) (RR = 2.32, 95% CI = 1.77 - 3.03, p < 
      0.00001). EBV therapy also reached clinically significant improvement in FEV1 (RR 
      = 2.96, 95% CI = 1.49 - 5.87, p = 0.002), in 6MWT (RR = 2.90, 95% CI = 1.24 - 
      6.79, p = 0.01), and in SGRQ (RR = 1.53, 95% CI = 1.22 - 1.92, p = 0.0002). Both 
      coils and EBV treatment achieved statistically significant absolute change in 
      FEV1, 6MWT, and SGRQ from baseline, also accompanied by serious adverse effects. 
      Furthermore, subgroup analysis showed there was no difference between homogeneous 
      and heterogeneous emphysema in coils group. However, IBV group failed to show 
      superior to conventional group. CONCLUSIONS: Current meta-analysis indicates that 
      coils or EBV treatment could significantly improve pulmonary function, exercise 
      capacity, and quality of life compared with conventional therapy. Coils treatment 
      could be applied in homogeneous emphysema, but further trials are needed.
FAU - Wang, Yong
AU  - Wang Y
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Lai, Tian-Wen
AU  - Lai TW
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Xu, Feng
AU  - Xu F
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Zhou, Jie-Sen
AU  - Zhou JS
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Li, Zhou-Yang
AU  - Li ZY
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Xu, Xu-Chen
AU  - Xu XC
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Chen, Hai-Pin
AU  - Chen HP
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Ying, Song-Min
AU  - Ying SM
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Li, Wen
AU  - Li W
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
FAU - Shen, Hua-Hao
AU  - Shen HH
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
AD  - State Key Lab of Respiratory Disease, Guangzhou, China.
FAU - Chen, Zhi-Hua
AU  - Chen ZH
AD  - Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital 
      of Zhejiang University School of Medicine, Hangzhou, China.
LA  - eng
PT  - Journal Article
DEP - 20170718
PL  - United States
TA  - Oncotarget
JT  - Oncotarget
JID - 101532965
PMC - PMC5652834
OTO - NOTNLM
OT  - bronchoscopic lung volume reduction therapy
OT  - endobronchial coils
OT  - endobronchial valves
OT  - meta-analysis
OT  - severe emphysema
COIS- CONFLICTS OF INTEREST The authors declare that they have no conflicts of 
      interest.
EDAT- 2017/11/05 06:00
MHDA- 2017/11/05 06:01
PMCR- 2017/09/29
CRDT- 2017/11/05 06:00
PHST- 2017/02/27 00:00 [received]
PHST- 2017/06/29 00:00 [accepted]
PHST- 2017/11/05 06:00 [entrez]
PHST- 2017/11/05 06:00 [pubmed]
PHST- 2017/11/05 06:01 [medline]
PHST- 2017/09/29 00:00 [pmc-release]
AID - 19352 [pii]
AID - 10.18632/oncotarget.19352 [doi]
PST - epublish
SO  - Oncotarget. 2017 Jul 18;8(44):78031-78043. doi: 10.18632/oncotarget.19352. 
      eCollection 2017 Sep 29.