The National Institute for Health and Care Excellence (NICE) Updated Guidance on Endobronchial Valves: What Was Behind the Decision and What Does it Mean for Pulmonologists?

In December 2017, the National Institute for Health and Care Excellence (NICE) updated its interventional procedures guidance, titled ‘Endobronchial valve insertion to reduce lung volume in emphysema’,1 to support the routine use of endobronchial valve therapy for emphysema. The NICE guidance states: 'Current evidence on the safety and efficacy of endobronchial valve insertion to reduce lung volume in emphysema is adequate in quantity and quality to support the use of this procedure provided that standard arrangements are in place for clinical governance, consent and audit.' NICE is the latest organisation to include endobronchial valves in its chronic obstructive pulmonary disease (COPD) treatment pathway, following the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy report for the diagnosis, management, and prevention of COPD;2 the German Society for Pneumology and Respiratory Medicine (DGP) guidance;3 and the Australian and New Zealand guidelines for the management of COPD;4 however, what does this mean to us as respiratory physicians?

[1]  Deutsche Gesellschaft für Geotechnik e.V.,et al.  Leitlinie zur Diagnostik und Therapie von Patienten mit chronisch obstruktiver Bronchitis und Lungenemphysem (COPD) , 2018, Pneumologie.

[2]  D. Slebos,et al.  Collateral Ventilation: Friend or Foe in Patients with Severe Emphysema , 2017, Respiration.

[3]  F. Herth,et al.  Endobronchial Valve Therapy in Patients with Homogeneous Emphysema. Results from the IMPACT Study. , 2016, American journal of respiratory and critical care medicine.

[4]  E. V. van Rikxoort,et al.  Predicting Lung Volume Reduction after Endobronchial Valve Therapy Is Maximized Using a Combination of Diagnostic Tools , 2016, Respiration.

[5]  E. V. van Rikxoort,et al.  Endobronchial Valves for Emphysema without Interlobar Collateral Ventilation. , 2015, The New England journal of medicine.

[6]  D. Hansell,et al.  Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (the BeLieVeR-HIFi study): a randomised controlled trial , 2015, The Lancet.

[7]  T. Welte,et al.  Multicentre European study for the treatment of advanced emphysema with bronchial valves , 2012, European Respiratory Journal.

[8]  F. Herth,et al.  Radiological and clinical outcomes of using Chartis™ to plan endobronchial valve treatment , 2012, European Respiratory Journal.

[9]  M. Noppen,et al.  Efficacy predictors of lung volume reduction with Zephyr valves in a European cohort , 2012, European Respiratory Journal.

[10]  G. McLennan,et al.  A randomized study of endobronchial valves for advanced emphysema. , 2010, The New England journal of medicine.

[11]  M. Krasna,et al.  Lung volume reduction surgery: technique, operative mortality, and morbidity. , 2008, Proceedings of the American Thoracic Society.

[12]  Konrad Schultz,et al.  Leitlinie der Deutschen Atemwegsliga und der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin zur Diagnostik und Therapie von Patienten mit chronisch obstruktiver Bronchitis und Lungenemphysem (COPD) , 2007 .

[13]  R. Pauwels,et al.  Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: GOLD Executive Summary Updated 2003 , 2004, COPD.

[14]  Steven Piantadosi,et al.  A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. , 2003, The New England journal of medicine.

[15]  P. Frith,et al.  The COPDX Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2003 , 2003, The Medical journal of Australia.

[16]  M. Greenstone,et al.  How well do we care for patients with end stage chronic obstructive pulmonary disease (COPD)? A comparison of palliative care and quality of life in COPD and lung cancer , 2000, Thorax.

[17]  D. R. Jones.  Predictors of operative mortality and cardiopulmonary morbidity in the National Emphysema Treatment Trial , 2007 .

[18]  E. Hoffman,et al.  Predictors of operative mortality and cardiopulmonary morbidity in the National Emphysema Treatment Trial. , 2006, The Journal of thoracic and cardiovascular surgery.